Long-term follow-up outcome and recurrence factors after stepwise ablation approach for non-paroxysmal atrial fibrillation

Objective To evaluate the efficacy of stepwise ablation approach for non-paroxysmal atrial fibrillation(AF), and the recurrence factors of atrial tachyarrhythmia(ATA). Methods A total of 174 consecutive patients with non-paroxysmal AF who underwent stepwise ablation for the first time were enrolled.According to the results of ablation, thpatients were divided into termination group (n=67) and non-termination group (n=107). The recurrence of ATA was compared between the two groups during long-term follow-up. Results During one year follow-up, 62(34.5%) cases had recurrence of ATA, the recurrence of ATA was less in termination group than thatin non-termination group (23.9% vs.43.0%, P=0.01). During the long-time follow-up[(54.3±13.8)months], 104 (59.8%) cases had recurrence of ATA. The recurrence of ATA was less in termination group than thatin non-termination group (44.8% vs.69.2%, P=0.001). Multivariate Cox regressionmodel analysis showed that non-termination(OR=1.612, 95%CI 1.152-2.256, P=0.005), longer AF duration(OR=1.003, 95%CI 1.001-1.006 P=0.020), larger left atrial dimension(OR=1.022, 95%CI 1.003-1.041 P=0.024) were the independent predictor of ATA recurrence after stepwise ablation approach (P<0.05). Conclusions Sinus rhythm conversion during stepwise ablation approach for non-paroxysmal AF will affect the recurrence of ATA.Non-termination, longer AF duration, and larger left atrial dimension were the independent predictors of ATA recurrence after ablation. Key words: Atrial fibrillation; Stepwise ablation; Recurrence