Radiofrequency ablation in atrial fibrillation. Predicting factors for restoration of sinus rhythm

Background

Atrial fibrillation (AF) is the most common sustained arrhythmia. It increases the risk of thromboembolic stroke, anticoagulation induced bleeding, and the overall mortality. Restoration of the sinus rhythm may improve the quality of life and reduce the mortality. The classic ‘cut and sew’ cox maze procedure is the gold standard; however, it is complex. Bipolar radiofrequency ablation is faster and simpler.

Methods

This study included 129 patients. They underwent bipolar radiofrequency ablation for their AF in concomitant with their cardiac surgery from 2008 throughout 2016 in Morriston hospital in UK. Patients were followed up for 6 months and divided according to their rhythm at 6 months into sinus group and AF group. Peri-operative data were collected. Comparison between the two groups was done to determine the predicting factors for the restoration of the sinus rhythm.

Results

42 patients were in AF in 6 months, while 87 patients restored their sinus rhythm. The two groups were compared according to different parameters. The results were tabulated and analysed using different tests. The significant predicting factors were left atrial diameter (P=0.004), type of AF (P=0.005), duration of AF (P<0.001), and the rhythm at discharge (P=0.020).

Conclusions

The predicting factors for the restoration of the sinus rhythm after AF ablation were: smaller left atrial diameter, paroxysmal atrial fibrillation, short duration of atrial fibrillation, and sinus rhythm at discharge.