Catheter Ablation of Atrial Fibrillation in Hypertrophic Cardiomyopathy: Long-Term Outcomes and Mechanisms of Arrhythmia Recurrence
Atrial Fibrillation Monday, October 21st, 2013CIRCEP: October 10, 2013
Background—Pulmonary vein antrum isolation (PVAI) in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF) has been reported to have satisfactory results at the mid and short-term follow-up. We determined the outcomes at the long-term follow-up of PVAI in these patients.
Methods and Results—We enrolled 43 patients with HCM and AF (28% paroxysmal AF). PVAI (paroxysmal AF) and posterior wall isolation with CFAE ablation (persistent and longstanding persistent AF) was the endpoint at the time of the index procedure and for repeat procedures during the first year of follow-up. In case of recurrent arrhythmia >1 year, high-dose isoproterenol challenge was used to disclose non-PV trigger sites. During the first year the success rate reached 91% (mean of 1.6 procedures). After a median follow-up of 42 months (range 38-48), 49% of the patients remained free from AF/atrial tachycardia. All patients underwent an additional procedure. PVA and posterior wall remained isolated in 82% of the cases, and extra-PV triggers were documented in all patients and targeted for ablation. After a median follow-up of 15 months (range 8 to 19) after the last procedure, 94% of the patients remained free from AF/atrial tachycardia off AADs. read more
