Single-catheter simplified stepwise approach to persistent atrial fibrillation ablation: A feasibility study
| Autor: | Frederic A. Sebag, Nicolas Lellouche, David Hamon, Manel Miled, Pierre Jorrot, Nicolas Mignot, Edouard Simeon, Jean-Marc Darondel, Olivier Villejoubert |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Catheters medicine.medical_treatment Catheter ablation Cardioversion Pulmonary vein Recurrence Internal medicine Atrial Fibrillation medicine Humans Sinus rhythm cardiovascular diseases Atrial tachycardia business.industry Atrial fibrillation General Medicine Ablation medicine.disease Catheter Treatment Outcome Pulmonary Veins Catheter Ablation cardiovascular system Cardiology Feasibility Studies medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Archives of Cardiovascular Diseases. 114:707-714 |
| ISSN: | 1875-2136 |
| DOI: | 10.1016/j.acvd.2021.06.012 |
| Popis: | Summary Background The strategy for atrial fibrillation ablation in persistent atrial fibrillation remains controversial. A single-catheter approach was recently validated for pulmonary vein isolation. Aim To evaluate the feasibility of this approach to performing persistent atrial fibrillation ablation, including pulmonary vein isolation and atrial lines, if needed. Methods We prospectively included 159 consecutive patients referred to our centre for a first persistent atrial fibrillation ablation between January 2018 and December 2018. All patients underwent pulmonary vein isolation. If the patient was still in atrial fibrillation (spontaneously or inducible), we subsequently performed a stepwise approach, including roof line, anterior mitral line, posterior box lesion and cavotricuspid isthmus line. Finally, if patient remained in atrial fibrillation at the end of the procedure, a synchronized direct-current cardioversion was applied to restore sinus rhythm. Results At baseline, 54 patients were in sinus rhythm and underwent pulmonary vein isolation. For patients in atrial fibrillation, after pulmonary vein isolation and ablation of additional lines, if needed, 18 patients were converted to atrial tachycardia and one directly to sinus rhythm; 96 were still in atrial fibrillation and underwent direct-current cardioversion. After a mean follow-up of 17 ± 6 months, 57 patients (36%) experienced atrial arrhythmia recurrence. No deaths, tamponades or phrenic nerve injuries were observed following the procedure. The main mode of arrhythmia recurrence was atrial fibrillation in 75% of cases and atrial tachycardia in 25% of cases. Conclusion A single-catheter approach, including pulmonary vein isolation and atrial lines, is feasible and safe in patients undergoing persistent atrial fibrillation ablation, with an acceptable success rate of 64% at mid-term follow-up. |
| Databáze: | OpenAIRE |
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