Dubravko Petrac, Berislav Radic,
Duško Hamel, Duro Vukosavic, Vjeran Nikolic.
Department of Arrhythmias and Cardiac Pacing, Sestre Milosrdnice University
Hospital, Zagreb, Croatia
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The clinical outcome after atrioventricular (AV)
junction radiofrequency ablation was comparatively evaluated in 30 patients with
paroxysmal and 20 patients with chronic atrial fi-brillation (AF). In all patients,
clinical evaluation included symptoms, NYHA class and exercise capacity before and after
ablation, mortality rate and incidence of thrombo-embolism after ablation.
At baseline evaluation, the incidence of cerebral symptoms, NYHA class I, higher left
ventricular ejection fraction and oxygen consumption during exercise test were
significantly more frequent in patients with paroxysmal AF (p < 0.0001, p < 0.002, p
< 0.001, p < 0.003), while the incidence of effort and rest dyspnea and NYHA class
III were more frequent in patients with chronic AF (p < 0.0003, p < 0.01, p <
0.01).
After RF AV junction ablation, the incidence of symptoms was similar in the both
groups, but patients with paroxysmal AF had higher reduction of cerebral symptoms (p <
0.0001), and patients with chronic AF had higher reduction of effort and rest dyspnea (p
< 0.001, p < 0.01). The improvement of NYHA class and oxygen consumption during
exercise test was significantly higher in patients with chronic AF (p < 0.0001, p <
0.02). In each group, one patient died and one patient had thromboembolism over a mean
follow-up period of 16 and 18 months, respectively.
Conclusion. Patients with chronic AF benefit from radiofrequency
ablation of AV junction more than those with paroxysmal AF, because they have 1) a higher
improvement rate of NYHA class and exercise capacity, and 2) comparable incidence of
symptoms, thromboembolism and mortality rate after ablation to patients with paroxysmal
AF.
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