Vol 24, No 6 (2017)
Original articles — Interventional cardiology
Published online: 2017-05-11

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Risk factors of atrial fibrillation recurrence despite successful radiofrequency ablation of accessory pathway: At 11 years of follow-up

Michał Orczykowski, Piotr Urbanek, Robert Bodalski, Paweł Derejko, Grzegorz Warmiński, Małgorzata Łodyga, Damian Łasocha, Łukasz Mazurkiewicz, Maciej Dąbrowski, Paweł Tyczyński, Joanna Zakrzewska-Koperska, Rafał Baranowski, Artur Oręziak, Maciej Sterliński, Maria Bilińska, Łukasz Szumowski
Pubmed: 28497840
Cardiol J 2017;24(6):597-603.


Background: Previous reports on patients with radiofrequency catheter ablation (RFCA) of accessory
pathway (AP) and atrial fibrillation (AF) include only short follow-up periods. The aim of this study
was to analyze predictors of recurrence of AF in patients after successful RFCA of APs over long term
follow-up periods.
Methods: Of the 1,007 patients who underwent non-pharmacological treatment of APs (between the
years 1993–2008), data of 100 consecutive patients were retrospectively analyzed (75 men, mean age
43.6 ± 14.7), with the longest period of follow-up (mean 11.3 ± 3.5 years) after successful RFCA of
AP. In Group 1, there were 72 patients (54 men, mean age 40.66 ± 13.85 years) without documented
episodes of AF after RFCA of AP. Group 2 consisted of 28 patients (21 men, mean age 50.79 ± 14.49
years) with AF episodes despite successful elimination of AP.
Results: In univariate analysis, patients from Group 1 were significantly younger at the time of ablation
than patients from Group 2 (40.66 ± 13.85 vs. 50.79 ± 14.49 years; p = 0.002), had shorter history
of AF episodes (4.11 ± 4.07 vs. 8.25 ± 7.50 years; p = 0.024) and had less frequently documented
atrial tachycardia (AT) prior to ablation (3.39 vs. 20.00%; p = 0.022). In multivariate analysis, the
history of AF in years (p = 0.043), was an independent risk factor for AF recurrences.
Conclusions: Older patient age, longer history of AF and AT prior to RFCA of APs identified a subgroup
of patients who required additional treatment. In the multivariate analysis, the history of AF in
years (p = 0.043) was a risk factor for AF recurrence.

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