摘要
Background Catheter ablation for atrial fibrillation （AF） has been demonstrated to be effective in a subsets of patients with AF. However, very few data are available in regard to patients with prior history of stroke undergoing catheter ablation. This study aimed to investigate the outcome of catheter ablation in AF patients with prior ischemic stroke. Methods Between January 2008 and December 2011, of 1897 consecutive patients who presented at Beijing An Zhen Hospital for treatment of drug-refractory AF, 172 （9.1%） patients in the study population had a history of ischemic stroke. All patients underwent catheter ablation and were followed up to assess maintenance of sinus rhythm and recurrence of symptomatic stroke. Results Among these 1897 patients, 1768 （93.2%） who had complete follow-up information for a minimum of six months were included in the final analysis. Patients in the stroke group （group I） and the no-stroke group （group II） were similar in regards to gender, body mass index （BMI）, history of diabetes, type of AF, and left atrial size. The patients in group I were older than those in group II, and had a higher incidence of hypertension, chronic heart failure, lower left ventricular ejection fraction （LVEF）, and higher CHADS2 scores. Six months after ablation, 107 （68.6%） patients in group I and 1403 （87.1%）in group II had discontinued warfarin treatment （P 〈0.001）. During a median follow-up of （633＋415） days, 65 patients in the group I and 638 in group II experienced AF recurrence, and five patients in group I and 28 in group II developed symptomatic stroke. The rates of AF recurrence and recurrent stroke were similar between group I and group II （41.7% vs. 39.6%, P=0.611; 3.2% vs. 1.7%, P=0.219; respectively）. Conclusion Catheter ablation of AF in patients with prior stroke is feasible and efficient.
Background Catheter ablation for atrial fibrillation （AF） has been demonstrated to be effective in a subsets of patients with AF. However, very few data are available in regard to patients with prior history of stroke undergoing catheter ablation. This study aimed to investigate the outcome of catheter ablation in AF patients with prior ischemic stroke. Methods Between January 2008 and December 2011, of 1897 consecutive patients who presented at Beijing An Zhen Hospital for treatment of drug-refractory AF, 172 （9.1%） patients in the study population had a history of ischemic stroke. All patients underwent catheter ablation and were followed up to assess maintenance of sinus rhythm and recurrence of symptomatic stroke. Results Among these 1897 patients, 1768 （93.2%） who had complete follow-up information for a minimum of six months were included in the final analysis. Patients in the stroke group （group I） and the no-stroke group （group II） were similar in regards to gender, body mass index （BMI）, history of diabetes, type of AF, and left atrial size. The patients in group I were older than those in group II, and had a higher incidence of hypertension, chronic heart failure, lower left ventricular ejection fraction （LVEF）, and higher CHADS2 scores. Six months after ablation, 107 （68.6%） patients in group I and 1403 （87.1%）in group II had discontinued warfarin treatment （P 〈0.001）. During a median follow-up of （633＋415） days, 65 patients in the group I and 638 in group II experienced AF recurrence, and five patients in group I and 28 in group II developed symptomatic stroke. The rates of AF recurrence and recurrent stroke were similar between group I and group II （41.7% vs. 39.6%, P=0.611; 3.2% vs. 1.7%, P=0.219; respectively）. Conclusion Catheter ablation of AF in patients with prior stroke is feasible and efficient.
基金
This study was supported by grants from the National Science Foundation Council of China （No. 81070147）, Beijing Municipal Science ＆ Technology Commission （No. D11110700300000） and Beijing Postdoctoral Science Foundation （No. 2011ZZ-04）.Acknowledgments： We appreciate Dr. Mohamed Salim for his great effort on this article.
