Background: Accumulating data have shown that the autonomic nervous
system is strongly implicated in the genesis of atrial fibrillation
(AF). The aim of this study was to assess the efficacy of a single
ablation procedure in patients with vagotonic, adrenergic and random
type of paroxysmal AF.
Methods and results: The clinical records of consecutive patients with
symptomatic, drug-refractory paroxysmal AF who underwent pulmonary vein
antral isolation were analysed. The study population consisted of 104
patients (64 males, mean age 57.9 +/- 10.9 years) with paroxysmal AF.
Based on AF triggers, patients were classified in those with vagotonic
(31.7%), adrenergic (17.3%) and random AF (51%). Subjects with
adrenergic and random AF tended to be older (p: 0.104) and displayed a
higher incidence of hypertension (p: 0.088) compared with those with
vagotonic AF. Following a mean follow-up period of 14.7 +/- 7.4 months,
74 patients were free from arrhythmia recurrence (71.2%). Late
arrhythmia recurrence (N3 months from the index procedure) occurred in
33.3%, 16.7% and 30.2% of patients with vagotonic, adrenergic and
random AF, respectively (p: 0.434). Cox regression analysis showed that
early AF recurrence [hazard ratio (HR) 15.76; 95% confidence interval
(CI) 5.45645.566, p<0.001], left atrial volume (HR 0.969; 95% CI
0.942-0.996, p: 0.025) and statin use (HR 6.828; 95% CI 2.078-22.437 p:
0.002) were independent predictors of late arrhythmia recurrence.
Conclusions: In this study cohort, the type of paroxysmal AF was not
associated with arrhythmia recurrence following left atrial ablation.
(C) 2013 Elsevier Ireland Ltd. All rights reserved
