Impact of Left Common Pulmonary Veins in the Contact-Force vs. Cryoballoon Atrial Fibrillation Ablation (CIRCA-DOSE) Study.

Autor: Larsen JM; Department of Cardiology, Aalborg University Hospital, Denmark.; Heart Rhythm Services, Department of Medicine, University of British Columbia, Canada., Deyell MW; Heart Rhythm Services, Department of Medicine, University of British Columbia, Canada.; Center for Cardiovascular Innovation, Vancouver, Canada., Macle L; Montreal Heart Institute, Department of Medicine, Université de Montréal, Canada., Champagne J; Université Laval, Quebec, Canada., Sarrazin JF; Université Laval, Quebec, Canada., Leong-Sit P; Department of Medicine, University of Western Ontario, London, Canada., Badra-Verdu M; Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada., Sapp J; Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Canada., Khairy P; Montreal Heart Institute, Department of Medicine, Université de Montréal, Canada., Andrade JG; Heart Rhythm Services, Department of Medicine, University of British Columbia, Canada.; Center for Cardiovascular Innovation, Vancouver, Canada.; Montreal Heart Institute, Department of Medicine, Université de Montréal, Canada.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2020 Jul 06. Date of Electronic Publication: 2020 Jul 06.
DOI: 10.1111/jce.14652
Abstrakt: Background: Concerns remain regarding the effectiveness of PVI using the fixed diameter non-compliant cryoballoon in the presence of a left common pulmonary vein (LCPV). We sought to evaluate the effectiveness of PVI performed by contact-force guided radiofrequency (CF-RF) versus second-generation cryoballoon-based ablation in patients with LCPV.
Methods and Results: We enrolled 346 patients with paroxysmal AF and randomized them to CF-RF or cryoballoon ablation. PV anatomy was not assessed prior to enrolment, and there were no exclusions based on PV anatomy. All patients received an implantable cardiac monitor. LCPV was observed in 13.6% of patients (47/346). Left atrial time and fluoroscopy time did not differ between those with and without LCPV (P=0.58 and P=0.06, respectively). Freedom from any atrial tachyarrhythmia at one year was observed in 46.8% with LCPV and 54.5% without LCPV (P=0.06). In those with LCPV the freedom from any atrial tachyarrhythmia did not differ between those randomized to CF-RF or cryoballoon ablation (HR for recurrence 1.19, 95% CI 0.53-2.65, P=0.69). In those with LCPV the AF burden was reduced to a similar extent with CF-RF and cryoballoon ablation (99.7% vs. 99.5%, respectively; P=0.97).
Conclusions: In this randomized clinical trial, the presence of a LCPV was associated with a trend towards higher rates of arrhythmia recurrence following PVI. No significant difference in arrhythmia recurrence was observed between patients with LCPV randomized to cryoballoon ablation or contact-force guided RF ablation, suggesting that either ablation modality is suitable in this population. (Cryoballoon vs. Irrigated Radiofrequency Catheter Ablation [CIRCA-DOSE], NCT01913522) This article is protected by copyright. All rights reserved.
(This article is protected by copyright. All rights reserved.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje