Impact of Complete Versus Incomplete Circumferential Lines Around the Pulmonary Veins During Catheter Ablation of Paroxysmal Atrial Fibrillation: Results From the Gap-Atrial Fibrillation-German Atrial Fibrillation Competence Network 1 Trial
| Autor: | Karl-Heinz, Kuck, Boris A, Hoffmann, Sabine, Ernst, Karl, Wegscheider, Andras, Treszl, Andreas, Metzner, Lars, Eckardt, Thorsten, Lewalter, Günter, Breithardt, Stephan, Willems, Thomas, Arentz |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Ablation of atrial fibrillation Catheter ablation 030204 cardiovascular system & hematology Asymptomatic Pulmonary vein 03 medical and health sciences Electrocardiography 0302 clinical medicine Heart Conduction System Heart Rate Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans 030212 general & internal medicine Prospective Studies Prospective cohort study Tachycardia Paroxysmal medicine.diagnostic_test business.industry Atrial fibrillation Middle Aged medicine.disease Surgery Treatment Outcome Pulmonary Veins Cardiology Catheter Ablation Female medicine.symptom Electrical conduction system of the heart Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Circulation. Arrhythmia and electrophysiology. 9(1) |
| ISSN: | 1941-3084 |
| Popis: | Background— Ablation of atrial fibrillation (AF) is an established treatment option for symptomatic patients. It is not known whether complete pulmonary vein isolation (PVI) is superior to incomplete PVI with regard to the patients’ clinical outcome. Methods and Results— Patients with drug-refractory, symptomatic paroxysmal AF were randomly assigned to either incomplete (group A) or complete PVI (group B). In group A, a persistent gap was intentionally left within the circumferential ablation line, whereas in group B, complete PVI without any gaps was intended. At 3 months, all patients underwent invasive reevaluation to assess the rate of persistent PVI. Clinical follow-up was based on daily 30-s transtelephonic ECG transmissions. Primary study end point was the time to first recurrence of (symptomatic or asymptomatic) AF. A total of 233 patients were enrolled (116 in group A and 117 in group B). AF recurrence within 3 months was observed in a total of 161 patients (136 [84.5%] with symptomatic and 25 [15.5%] with asymptomatic AF); AF recurred in 62.2% of group B patients and 79.2% of group A patients ( P Conclusions— This study proves the superiority of complete PVI over incomplete PVI with respect to AF recurrence within 3 months. However, the rate of electric reconduction 3 months after PVI is high in patients with initially isolated PVs. Clinical Trial Registration— URL: http://clinicaltrials.gov ; Unique identifier: NCT00293943. |
| Databáze: | OpenAIRE |
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