Abstract 14156: Termination of Atrial Fibrillation During Ablation Predicts Long-Term Success

Background: The predictive value of termination of atrial fibrillation (AF) during catheter ablation (CA) during a long-term follow-up is not known. Methods: We studied the predictive value of AF termination (spontaneous or induced) during ablation in patients who underwent CA of persistent and paroxysmal AF and followed them for recurrence of AF/atrial flutter (FL). Results: Of 187 patients (male: 75%, mean age: 60.3 ± 10.7 years) who underwent CA of AF, 65 (34.8%) patients had termination during the initial CA. A mean number of 1.4 ± 0.6 ablations were performed during follow-up in both groups. There were no significant differences in baseline characteristics including age, gender, race, body mass index, left ventricular ejection fraction, and presence of hypertension, diabetes, and valvular disease. During a median (±1SE) follow-up of 5.23 ± 0.17 years, a significantly higher percentage of patients who had termination during CA were in sinus rhythm as compared to patients who did not have termination during CA (87.6 vs 63.1%, p < 0.001). Cox regression analysis confirmed termination of AF during ablation as a predictor of whether the patient was in sinus rhythm at time of last follow-up (OR: 0.24, 95% CI 0.09 to 0.62, p = 0.003). Kaplan-Meier survival analysis shows significantly decreased time to recurrence in patients who did not have AF termination than patients who had AF termination during CA. Conclusion: The present study identifies termination of AF during CA as a predictor of successful ablation during 5-year follow-up.