Local captures of the pulmonary vein myocardium are a predictor of improved long-term results of radiofrequency ablation of nonparoxysmal atrial fibrillation

Aim. To evaluate the prognostic value of local captures after pulmonary vein isolation in patients with nonparoxysmal atrial fibrillation (AF) for the long-term results of radiofrequency ablation (RFA).
Methods. A single-center observational prospective study. The total number of patients 110. All patients underwent primary catheter ablation for nonparoxysmal AF. During the operation, the activity of pulmonary veins and the presence of local captures were assessed. Patients with local captures in at least one pulmonary vein were included in the first group. Patients who had no local captures were included in the second group. The number of patients in the first group is 54 patients, the number of patients in the second group is 56 patients. The groups had no statistically significant differences in the main indicators -gender, weight, age, duration of medical history, volume of the left atrium and left ventricular ejection fraction, as well as in concomitant pathology. The time of RFA and fluoroscopy, and the duration of operations between the groups also had no statistically significant differences.
Results. The follow-up period was 800 [286.5;800] days. The overall effectiveness of the treatment was 68.2% (75 patients out of 110), considering repeated operations. In the group with local captures, sinus rhythm was maintained at the end of the follow-up period in 42 out of 54 patients (77,7%), in the group without local captures in 33 out of 56 patients (58,9%). The difference is statistically significant (odds ratio 2,439 (95% confidence interval 1,060 -5,615 p=0,034). The presence of local captures in the construction of a multifactorial logistic regression model is a predictor of the effectiveness of RFA (χ2=14,710; p=0,012).
Conclusion. In this study, local captures in the pulmonary veins in patients with nonparoxysmal atrial fibrillation were a predictor of improved long-term results of radiofrequency ablation.

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