AF cycle length predicts ablation success

A longer atrial fibrillation (AF) cycle length, measured with surface ECG, predicts successful catheter ablation in patients with persistent atrial fibrillation, research indicates. Of 90 patients in the study who underwent ablation for persistent AF, 76 (84%) were free from recurrent atrial tachyarrhythmia 18 months after the procedure. On initial analysis, shorter continuous AF, longer surface ECG AF cycle length, and smaller left atrium were all correlates of arrhythmia termination. However, further analysis showed that the ECG AF cycle length finding was the only independent predictor of arrhythmia termination (p < 0.01). At one-year follow-up, sinus rhythm was maintained in approximately 93% of patients with AF cycle length more than 142 ms compared with approximately 68% in patients with an AF cycle length less than 142 ms, the study authors reported in JACC. “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 concluded. An accompanying editorial said that the guidelines were “attractive in their simplicity” but the results of the Catheter Ablation versus Antiarrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial should provide further confirmation. JACC 2009; 54:788-795....