Catheter ablation outcomes
A complete pulmonary vein isolation was performed in all subjects. A left atrial (LA) posterior wall isolation was achieved in 36 (80%) patients. A mitral isthmus linear ablation, cavotricuspid isthmus linear ablation, and superior vena cava isolation were performed in 15 (33%), 29 (64%), and one (2%) patient, respectively. The ablation procedural characteristics and periprocedural complications are shown in Suppl 1. After the first ablation, 10 (22%) patients had recurrences of AF within one year and 28 (62%) had an AF recurrence during the study period. Among the patients with AF recurrences, 25 (89%) received a second procedure. Eventually, during a mean follow-up period of 34 ± 27 months after 1.7 ± 0.8 ablation procedures, sinus rhythm was maintained in 36 (80%) patients (Figure 2). Of the 36 patients free from AF recurrence after the last ablation, 21 were taking antiarrhythmics including amiodarone (n=19) and cibenzoline (n=7). During the follow-up, 4 of 45 (9%) patients in the ablation group and 7 of 45 (16%) patients in the control group had hospitalizations due to heart failure (log-rank P=0.49). Death occurred in one (2%) patient in the ablation group and six (13%) in the control group (log-rank P=0.01). The cause of death was a neoplasm (N=1) in the ablation group, interstitial pneumonia (N=1), a neoplasm (N=1), unknown (N=3), and heart failure (N=1) in the control group. During the follow up, an angiotensin converting enzyme inhibitor (ACEI) (one vs. zero patient P=0.32) and diuretics (four vs. three patients P=0.70) were discontinued in the CA and control group, respectively. On the other hand, ACEIs (three vs. one patient P=0.31), angiotensin II receptor blockers (two vs. four patients P=0.40), and diuretics (two vs. two patients P=1.00) were started in the CA and control groups during the study period.