Objective: To investigate the safety and efficacy of circumferential pulmonary vein with additional linear ablation in treatment of persistent and permanent atrial fibrillation (AF), and to identify possible predictors of recurrence of AF.
Methods: The clinical data of 127 patients with persistent and permanent AF who had undergone circumferential pulmonary vein with additional linear ablation from January 2006 to December 2006 in multiple electrophysiological centers were collected, success rate and recurrence rate, cardiac function and atrial arrhythmias after ablation, and complications were analyzed. The relationship between the recurrent AF and clinical and echocardiographic variables was investigated.
Results: A mean follow-up of 9 +/- 4 months showed that the success rate and recurrence rate were 68.5% and 31.5% respectively. After, both the left atrium diameter, left ventricular end diastole diameter, and left ventricular ejection fraction of the patients with successful ablation were (41 +/- 8) mm, (49 +/- 7) mm, and (61 +/- 8)% respectively, all not significantly different from those before ablation [(43 +/- 7) mm, (48 +/- 6) mm, and (62 +/- 10)% respectively, all P > 0.05]. After ablation the episodes of atrial tachyarrhythmias and atrial premature beat significantly increased (P < 0.05 and P < 0.01). The only complication was ecchymoma that occurred in 3 patients (2.4%). Female gender and left atrium enlargement were risk factors of recurrent AF (P < 0.05 and P < 0.05).
Conclusion: Circumferential pulmonary vein with additional linear ablation is a safe and moderately effective treatment for persistent and permanent atrial fibrillation.