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ECG finding predicts success with atrial fibrillation treatment

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – A longer atrial fibrillation (AF) cycle length, measured with surface ECG, predicts successful catheter ablation in patients with this common arrhythmia, new research indicates.

Prior research has shown that the AF cycle length, measured from the left atrial appendage, can predict ablation success. However, this testing can only be conducted at the time of treatment.

The goal of the current study, by Dr. Seiichiro Matsuo at Hopital Cardiologique du Haut-Leveque in Bordeaux, France and colleagues, was to determine if surface ECG AF cycle length, a non-invasive test, and possibly other clinical variables could also predict treatment success. Included in the analysis were 90 patients with long-lasting persistent AF who underwent catheter ablation.

The procedures were successful at terminating AF in 76 patients (84%), according to the report in the Journal of the American College of Cardiology for August 25.

On initial analysis, shorter continuous AF, longer surface ECG AF cycle length, and smaller left atrium were all correlates of arrhythmia termination. Further analysis, however, showed that the ECG AF cycle length finding was the only independent predictor of arrhythmia termination (p < 0.01).

Correlates of sinus rhythm maintenance were shorter duration of continuous AF, longer surface ECG AF cycle length, and a smaller left atrium. On multivariate analysis, the association with left atrium size was no longer statistically significant.

“The measurement of the surface ECG AF cycle length and the duration of continuous AF could help with patient selection for catheter ablation of long-lasting persistent AF,” the authors conclude.

J Am Coll Cardiol 2009;54:788-795.