The Long-term Thromboembolic Event Analysis in Atrial Fibrillation Patients With Radiofrequency Catheter Ablation
Objective: To observe the thromboembolic event in atrial fibrillation (AF) patients with long-term successful radiofrequency catheter ablation (RFCA), and to study the relationship between thromboembolic event and CHA2DS2-VASC score in order to guide the anticoagulation strategy for AF patients.
Methods: A total of 321 AF patients who received RFCA in our hospital from 2000-01 to 2009-05 were studied. There were 261 patients with paroxysmal AF and 60 with persistent AF, they were followed-up for (66.7±26.9) months. The patients were divided into 2 groups according to AF recurrence condition as Non-recurrence group, n=204 and Recurrence group, n=117. The relationship between thromboembolic event and CHA2DS2-VASC score was studied.
Results: The Non-recurrence group had significantly lower rate of thromboembolism than that in Recurrence group (1.96% vs 7.69%), P=0.017. In both groups, the patients with CHA2DS2-VASC score < 2 had much lower rate of thromboembolism than those with CHA2DS2-VASC score ≥ 2, (0% vs 5%), P=0.023 and (4.45% vs 17.24%), P=0.041. The patients with CHA2DS2-VASC score<2 in Non-recurrence group had lower rate of thromboembolism than those in Recurrence group (0%vs 4.45%), P=0.029. The rate of thromboembolism had no statistic meaning between 2 groups in patients with CHA2DS2-VASC score≥2 (5%vs 17.24%), P=0.054.
Conclusion: The AF patients who received RFCA without AF recurrence in long-term follow-up had the lower rate of thromboembolic event, CHA2DS2-VASC score was important for evaluating such event. The patients with CHA2DS2-VASC score < 2 could consider stopping warfarin anticoagulation, while the patients with CHA2DS2-VASC score ≥ 2 might be beneifted for warfarin anticoagulation.