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GW24-e2483 Catheter ablation of atrial fibrillation in patients with autoimmune rheumatic diseases

Objectives Autoimmune Rheumatic Diseases (ARDs) is one of the important underlying diseases of atrial fibrillation (AF). The outcomes after radiofrequency catheter ablation of AF in patients with ARD have not yet been reported. We investigated the impact of ARD on the recurrence of AF after radiofrequency catheter ablation. Methods From April 2008 to September 2012, Consecutive patients with AF who underwent circumferential pulmonary vein ablation guided 3-D mapping system were enrolled in the retrospective study. The recurrence was defined as atrial tachyarrythmia lasting more than 30 seconds beyond one month washout period. We assessed 15 patients who had ARD and underwent radiofrequency catheter ablation of AF. Results Ten patients had rheumatoid arthritis (RA), 2 had a primary Sjögren’s syndrome (PSS), 1 had a Ankylosing Spondylitis (AS), 1 had Antiphospholipid syndrome (APS) + PSS, 1 had a Microscopic Polyangiitis (MPA). For controls, we selected 60 sex-, age-, and procedure era–matched non- ARD patients who received radiofrequency catheter ablation for AF (4 controls for autoimmune rheumatic diseases each patient). The AF recurrence rate in the ARD group (33.3%, 5/15) was similar to that in the control group (35%, 21/60; P = 0.66) during a mean follow-up of 462 ± 416 days. Patient with ARD had significantly higher CRP(1.81 ± 2.35 mg/dl vs 6.14 ± 9.50 mg/dl, P = 0.0018). All patient with ARD had early recurrence. Conclusions Radiofrequency catheter ablation can be performed safely for AF in ARD patients with a comparable success rate to that in patients without ARD. Patients with ARD had early recurrence. It is probably mediated by inflammation.