Does left atrial epicardial conduction time reflect atrial fibrosis and the risk of atrial fibrillation recurrence after thoracoscopic ablation? Post hoc analysis of the AFACT trial
| Autor: | R Wesselink, J Neefs, N W E van den Berg, E R Meulendijks, M M Terpstra, M Kawasaki, F A Nariswari, F R Piersma, W J P van Boven, A H G Driessen, J R de Groot |
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| Přispěvatelé: | ACS - Heart failure & arrhythmias, Graduate School, Cardiology, ACS - Amsterdam Cardiovascular Sciences, Cardiothoracic Surgery, ACS - Pulmonary hypertension & thrombosis, Cardio-thoracic surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Wesselink, R, Neefs, J, van den Berg, N W E, Meulendijks, E R, Terpstra, M M, Kawasaki, M, Nariswari, F A, Piersma, F R, van Boven, W J P, Driessen, A H G & de Groot, J R 2022, ' Does left atrial epicardial conduction time reflect atrial fibrosis and the risk of atrial fibrillation recurrence after thoracoscopic ablation? Post hoc analysis of the AFACT trial ', BMJ Open, vol. 12, no. 3, e056829 . https://doi.org/10.1136/bmjopen-2021-056829 BMJ open, 12(3):e056829. BMJ Publishing Group BMJ Open, 12(3):e056829. BMJ Publishing Group |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesTo determine the association between left atrial epicardial conduction time (LAECT), fibrosis and atrial fibrillation (AF) recurrence after thoracoscopic surgical ablation of persistent AF.SettingSingle tertiary care centre in the Netherlands.ParticipantsPatients with persistent AF from the randomised Atrial Fibrillation Ablation and Autonomic Modulation via Thoracoscopic Surgery (AFACT)-trial were included. Patients eligible for thoracoscopic AF ablation were included, full inclusion and exclusion criteria were previously published. All patients underwent thoracoscopic ablation, encompassing pulmonary vein isolation with an additional roof and trigone lesion. In patients with conduction block across the roof and trigone lesion, LAECT was measured. LAECT was defined as the time to local activation at one side of the roofline on pacing from the opposite side. Collagen fibre density was quantified from left atrial appendage histology.Outcome measuresPrimary outcome: AF recurrence during 2 years of follow-up.Results121 patients were included, of whom 35(29%) were women, age was 60.4±7.8 and 51% (62) had at least one AF recurrence during 2 years of follow-up. LAECT was longer in patients with versus without AF recurrence (182±43 ms vs 147±29 ms, pConclusionLAECT is correlated with collagen fibre density and BMI and is independently associated with AF recurrence in patients with persistent AF. In these patients, LAECT appears to reflect substrate characteristics beyond clinical AF type and left atrial volume.Trial registration numberNCT01091389. |
| Databáze: | OpenAIRE |
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