Introduction: There are still many unsolved issues that have accumulated as our experience is been growing. There is no consensus on the protocol of antiarrhythmic therapy before and after ablation of atrial fibrillation.
Materials and Methods: From 2012 up to 2013 we treated 63 patients. We used Chilli II closed irrigated and Blazer Open Irrigated systems (Boston Scientific), AcuNav ultrasound 10 F sensors (Siemens). In some patients (pts) antiarrhythmic treatment (AAT) by amiodarone or 1C class drugs before and for 3 months after ablation have been used. Several patients were treated only by ?-blockers after ablation procedure.
1st group – catheter ablation procedure in paroxysmal AF – 42 patients / 12 pts without AAT
2nd group – catheter ablation procedure in persistent AF patients – 21 / 6 pts without AAT.
Results: Mean age was 56 years, left atrial size was 4.1 cm (70.3 ml) without significant differences in the groups. We made PV-isolation protocol with the following provoking AF by rapid left atrial stimulation. We extended our protocol in 2nd group to posterior wall isolation, ablation of CFAFs, CS-isolation, trying to get a sinus rhythm during delivering of ablating lesions. In 1st group we’ve got 85.7% of success, and 76.2% in 2nd one after 3 months of follow up. Patients with recurrent AF in 1st group distributed equally (3x3) among pts with or without AAT. In patients with persistent AF recurrency of arrhythmia prevailed among patients with AAT.
Conclusions: AF ablation is very effective and safe even in persistent and permanent AF
Clear background without AAT before and after ablation helps us to evaluate true results of AF-treatment, especially in patients with persistent AF.
There is no clear dependency of AAT in recurrency of atrial fibrillation after ablation procedure.