engleski

The clinical ouctome of patients with atrial fibrillation after radiofrequency ablation of the atrioventricular junction

The clinical outcome after atrioventricular (AV) junction radiofrequency ablation was comparatively evaluated in 30 patients with paroxysmal and 20 patiens with chronic atrial fibrillation (AF). In all patients, clinical evaluation included sympmtoms, NYHA class and exercise capacity before and after ablation, mortality rate and incidence of thromboembolism after ablation. At baseline evaluation, the incidence of cerebral symptoms, NYHA class I, higher lef ventricular ejection fraction and oxygen consumption during exercise test were significntly more frequent in patients with paroxysmal AF (p<0.0001, p<0.002, p<0.001, p<0.003), while the incidence of efort 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<0.001), 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 more from radiofrequency ablation of AV junction 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.

atrial fibrillation; radiofrequency ablation; atrioventricular junction

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