Evaluation of optimal treatment approach in patients with early recurrence of atrial fibrillation after the first ablation procedure

Abstract

182 patients with paroxysmal AF underwent ablation (circumferential pulmonary vein isolation with linear lesions) and were monitored with an implantable cardiac monitor (Reveal XT, Medtronic). Patients were randomly assigned to group 1 or group 2. Group 1 patients were treated only with antiarrhythmic drugs for 6 weeks, with no early reablation during the 3-month postablation period. In the case of AF recurrence after the 3-month postablation period, patients underwent reablation. Group 2 patients were treated according to the onset mechanism of AF recurrences, as detected and stored by the implantable cardiac monitor: antiarrhythmic drug therapy, but no reablation if AF was not preceded by triggers; early reablation if premature atrial beats or atrial tachycardias or flutter triggered AF. All patients were followed up for 1 year to assess the sinus rhythm maintenance in each group. On 12-month follow-up examination, 67 patients (76%) out of 88 in group 1 and 78 patients (92%) out of 89 in group 2 had no AF recurrences (P<0,009 versus group 1). The patients with AF recurrences caused by a trigger mechanism after the first ablation demonstrated high long-term efficacy after early reablation.

Keywords

• ФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ
• АБЛАЦИЯ
• ИМПЛАНТИРУЕМЫЙ АППАРАТ ДЛИТЕЛЬНОГО МОНИТОРИРОВАНИЯ ЭКГ