37 Recurrence of atrial fibrillation after efficacious radiofrequency transcatheter ablation of regular supraventricular tachycardia

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Background: in assessing the role of a therapy in atrial fibrillation (AF) management, crucial is the impact of asymptomatic recurrence.We compared, in a prospective and randomized trial, the incidence of both symptomatic and asymptomatic AF recurrences in patients with paroxysmal or persistent AF during antiarrhythmic drug (AAD) combined with radiofrequency catheter ablation (RCA) (Group A) or AAD therapy alone (Group B).Methods: 131 patients were followed during 3-month follow-up, of them, 64 pts underwent RCA of pulmonary vein ostia plus right and left atrium isthmus ablation, combined with AAD, and 67 were on AAD.Patients were scheduled to obtain a daily, 30 seconds transtelephonic ECG (TTECG)(CG2206,Sorin Lifewatch); a further TTECG was obtained the event of symptoms.Results: a total of 11043 TTECG were obtained (mean 84.3/patient).In group A 20/64 (31.2%) had AF recurrences compared with 50/67 (74.6%) group B patients (p <0.001).The percentage of patients with both symptomatic and asymptomatic recurrence were not different between the two groups (6/20 in group A, 11/53 in group B).Also the percentage of patients with only asymptomatic AF recurrence was not different between the two groups (6/20, 30%, in group A; 7/53, 13%, in group B) (p=0.1).The overall percentage of patients with asymptomatic AF recurrence was significantly higher in group A (12/20 patients, 60%) compared with group B (18/53, 33.9%)(p=0.04).Conclusions: asymptomatic AF recurrence are more frequent in patients who underwent RCA as compared with patients treated with AAD alone.Placebo effect, denervation and cavo-tricuspid isthmus ablation might contribute to this.

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