Characteristics and long-term catheter ablation outcome in long-standing persistent atrial fibrillation patients with non-pulmonary vein triggers

Yuan Hung, Li Wei Lo, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Fa Po Chung, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Rohit Walia, Abigail Louise D. Te, Shinya Yamada, Chung-Hsing Lin, Yao Ting Chang, Chin Yu Lin, Chao Shun Chan, Ying Chieh Liao, Sunu Raharjo, Suresh Allamsetty, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


Background There are limited literatures regarding the non-pulmonary vein (NPV) triggers in long-standing persistent atrial fibrillation (LSPAF). The goal of the present study was to investigate the characteristics and long-term outcome of catheter ablation among these patients. Methods The study included 776 patients (age 53.59 ± 11.38 years-old, 556 males) who received catheter ablation for drug-refractory atrial fibrillation (AF). We divided these patients into 3 groups. Group 1 consisted of 579 patients with paroxysmal AF (PAF), group 2 consisted of 103 patients with persistent AF (PerAF) and group 3 consisted of 94 patients with long-standing persistent AF (LSPAF). The average follow-up duration was 28.53 ± 23.21 months. Results The clinical endpoint was the recurrence of atrial tachyarrhythmia. Among these 3 groups, higher percentages of male (93.6%, P < 0.001), NPV triggers (44.7%, P < 0.001), longer AF duration (6.65 ± 6.72 years, P = 0.029), larger left atrium diameter (44.44 ± 6.79 mm, P < 0.001), and longer procedure time (181.94 ± 70.02 min, P < 0.001) were noted in LSPAF. After the first catheter ablation, the recurrence rate of AF was highest in LSPAF (Log Rank, P < 0.001). Larger left atrium diameters (LAD) (P = 0.006; HR: 1.063; CI: 1.018–1.111) and NPV triggers (P = 0.035; HR: 1.707; 1.037–2.809) independently predicted AF recurrence in LSPAF. Conclusions Compared with PAF and PerAF, LSPAF had a higher incidence of NPV triggers and worse long-term outcome after catheter ablation. NPV triggers and LAD independently predicted AF recurrence after catheter ablation in LSPAF.

Original languageEnglish
Pages (from-to)205-211
Number of pages7
JournalInternational Journal of Cardiology
Publication statusPublished - Aug 15 2017
Externally publishedYes


  • Ischemic stroke
  • Long-standing persistent atrial fibrillation
  • Outcome
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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