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Good responders to catheter ablation for long-standing persistent atrial fibrillation: Clinical and genetic characteristics

 Jin-Kyu Park  ;  Ji-Young Lee  ;  Pil-Sung Yang  ;  Tae-Hoon Kim  ;  Eunsoon Shin  ;  Junbeom Park  ;  Jae-Sun Uhm  ;  Boyoung Joung  ;  Moon-Hyoung Lee  ;  Hui-Nam Pak 
 JOURNAL OF CARDIOLOGY, Vol.69(3) : 584-590, 2017 
Journal Title
Issue Date
Atrial Fibrillation/genetics* ; Atrial Fibrillation/pathology ; Atrial Fibrillation/surgery* ; Catheter Ablation*/adverse effects ; Female ; Genotype ; Heart Atria/pathology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Polymorphism, Single Nucleotide ; Postoperative Complications ; Recurrence ; Time Factors ; Treatment Outcome
Ablation ; Genetic polymorphism ; Long-standing persistent atrial fibrillation
BACKGROUND: Radiofrequency catheter ablation (RFCA) for long-standing persistent atrial fibrillation (L-PeAF) is challenging and has a relatively high recurrence rate. We explored clinical and genetic characteristics associated with being good responders (no early or clinical recurrence within 12 months in the absence of anti-arrhythmic drugs) to RFCA among patients with L-PeAF. METHODS: Of 1319 patients in the Yonsei AF Ablation Cohort, this study included 141 consecutive patients with L-PeAF (80.9% male, age 57.8±9.7 years) who were followed >12 months after RFCA. RESULTS: During 25 (19-35) months follow-up, the recurrence rate was 39%, and 38 patients (27%) were categorized as good responders, those had a shorter AF duration (p=0.010), and smaller left atrial (LA) size (p=0.033) than others. The rs2106216 (16q22/ZFHX3) genetic polymorphism was independently associated with being a good responder in multivariate analysis (adjusted OR=2.70, 95% CI 1.41-5.14, p=0.003), after adjusting for LA size and AF duration. The rs2106261 had predictive value for clinical recurrence of AF after RFCA among patients with an AF duration 12-65 months (log rank, p=0.025). CONCLUSIONS: Despite a relatively high recurrence rate after RFCA for L-PeAF, patients with a shorter AF duration and smaller LA size showed a more favorable outcome. The rs2106216 polymorphism (ZFHX3) was independently associated with being good responders to RFCA for L-PeAF, especially with AF duration 12-65 months.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Yang, Pil Sung(양필성)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
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