Efficacy of radiofrequency catheter ablation in athletes with atrial fibrillation

Koopman, Pieter; Nuyens, Dieter; Garweg, Christophe; La Gerche, Andre; De Buck, Stijn; Van Casteren, Lieve; Alzand, Becker; Willems, Rik; Heidbuchel, Hein

doi:10.1093/EUROPACE/EUR142

Title

Efficacy of radiofrequency catheter ablation in athletes with atrial fibrillation

Author

Koopman, Pieter

Nuyens, Dieter

Garweg, Christophe

La Gerche, Andre

De Buck, Stijn

Van Casteren, Lieve

Alzand, Becker

Willems, Rik

Heidbuchel, Hein

Abstract

Aims Endurance sports activities have been associated with the development of atrial fibrillation (AF). Pulmonary vein isolation (PVI) by means of radiofrequency catheter ablation has been established as an effective treatment for AF. The aim of the present study was to analyse the efficacy of AF ablation in athletes. Methods and results We compared procedural outcome and median term follow-up in 94 consecutive athletes (>3 h of sports/week for >= 10 years or >= 1500 h lifetime) who underwent PVI (94% men, 51 +/- 8 years, 87% paroxysmal AF, left atrial (LA) diameter 40 +/- 8 mm, mean follow-up 41 months), and 41 contemporary controls. Sixty-three per cent of athletes performed endurance sports (running, cycling, swimming, and rowing). Documented focal induction of AF and failed treatment with >= 1 anti-arrhythmic drug were pre-requisites for selection of ablation treatment. Patients with long-standing persistent or permanent AF or an LA diameter >= 55 mm were not considered for ablation. Median lifetime cumulative hours of sports was 8638 (4175-13 688) in athletes vs. 450 (280-600) in controls (P < 0.001). Other baseline characteristics except for gender (94 vs. 66% men, respectively, P < 0.001) were comparable between both groups, as was the total number of ablation procedures per patient (1.2 +/- 0.5, P = 0.62). Survival analysis showed similar AF recurrence rate after a first ablation for controls and endurance athletes, though non-endurance athletes had a significantly higher AF recurrence rate (48 vs. 46 vs. 34% freedom from AF at 3 year follow-up after a single ablation, P = 0.04). Final outcome after all ablations was similar (87 vs. 84 vs. 85% freedom from AF at 3-year follow-up, P = 0.88). No other independent predictor for AF recurrence was identified. Conclusion In patients with documented focal induction of non-permanent AF and absence of structural heart disease, PVI is as effective in endurance athletes as in other patients.

Language

English

Source (journal)

Europace. - Oxford

Publication

Oxford : 2011

ISSN

1099-5129

DOI

10.1093/EUROPACE/EUR142

Volume/pages

13 :10 (2011) , p. 1386-1393