Pulmonary Vein Isolation for Atrial Fibrillation: The Result of Long Term Follow Up

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Introduction: Although pulmonary vein isolation (PVI) is an effective therapy for patients with drug refractory atrial fibrillation (AF), the late reccurence in long term is not well known. Method and Result: We followed consecutive 101 patients with AF (mean age 58.5 y.o, Male 74, Paroxysmal AF 90, Chronic AF 11) who underwent PVI between 2005 and 2008. Ablation end point was PVI confirmed with circular mapping catheter. Isolation of four pulmonary veins was successful in 99% of patients. Follow up periods was at a mean 40 months (range 36–56 months). 14 patients received second procedure, 1 patient received third procedure. Including second and third procedure, 69 patients (68.3%) maintained SR without anti arrhythmic drugs (AADs), 81 patients (80.2%) maintained SR with AADs. Especially, in cases of paroxysmal AF, 64 patients (71.1%) maintained SR without AADs and 75 patients (83.3%) maintained SR with AADs. This is significantly higher SR maintenance rate compared with Chronic AF. In the first year (within 12 months) after ablation, 15 patients (14.9%) had early recurrence and over long term follow-up (at least 36 months), only 3.0% had late arrhythmia recurrence defined as occurring beyond the first year post ablation. Conclusion: PVI is effective therapy for long term maintenance of sinus rhythm and control of symptoms in patients with drug resistant paroxysmal AF.