Catheter Ablation of Atrial Fibrillation after Pericardiectomy: Multi- Center Experience in China

Background: To study the effectiveness and safety of atrial fibrillation (AF) catheter ablation after pericardiectomy. Methods: Data of 24 consecutive AF patients after pericardiectomy underwent catheter ablation from five centers were collected and analyzed retrospectively. All patients were followed up at 1, 3, and 12 months after catheter ablation. Results of a repeated blood test, electrocardiogram, and echocardiography during follow-up were also collected. Adverse events such as recurrence of AF, heart failure, stroke/transient ischemic attack (TIA) and minor, and major bleeding were recorded. All patients underwent brain magnetic resonance imaging (MRI) at the end of 12 months follow-up. Results: Patients were young (20-73 years old, 48.1 +/- 11.0). Fifteen (62.5%) patients were male. CHA2DS2-VASc score (0-3, 0.21 +/- 0.41) was low in these 24 patients. Among these patients, 11 (45.8%) were paroxysmal AF, 8 (33.3%) were persistent AF, and 5 (20.8%) were long-lasting persistent AF. Left atrium diameter over 45 mm was detected in 17 (70.8%) patients. All patients underwent catheter ablation successfully. No periablation procedure-related complication happened. Oral anticoagulant therapy was stopped 3 months after the final ablation. Anti-arrhythmia drugs were continued for all patients after ablation. For 12 months follow-up, AF recurred in 10 (41.7%) patients 3-7 months after the first ablation. MRI detected silent cerebral infarction (SCI) in 2 (8.3%) patients. No other adverse events occurred during follow-up. Conclusions: It is safe for AF patients to undergo catheter ablation after pericardiectomy, but the rate of recurrence of AF is high.