Acute and early outcomes of focal impulse and rotor modulation (FIRM)-guided rotors-only ablation in patients with nonparoxysmal atrial fibrillation
| Autor: | J. David Burkhardt, Patrick Müller, Sanghamitra Mohanty, Phillipp Halbfaß, Carola Gianni, Rodney Horton, Gery Tomassoni, Chintan Trivedi, Anja Schade, Amin Al-Ahmad, Andrea Natale, Thomas Deneke, G. Joseph Gallinghouse, Rong Bai, Patrick Hranitzky, Yalçın Gökoğlan, Javier Sanchez, Mahmut F. Güneş, Tamara Metz, Luigi Di Biase |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Settore MED/11 - Malattie dell'Apparato Cardiovascolare Catheter ablation 030204 cardiovascular system & hematology 03 medical and health sciences Imaging Three-Dimensional Postoperative Complications 0302 clinical medicine Heart Conduction System Physiology (medical) Internal medicine Atrial Fibrillation Humans Medicine In patient Prospective Studies 030212 general & internal medicine Prospective cohort study Adverse effect Atrial tachycardia business.industry Incidence Body Surface Potential Mapping Atrial fibrillation Equipment Design Middle Aged medicine.disease Ablation United States Europe Treatment Outcome Catheter Ablation Cardiology Female Electrical conduction system of the heart medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Heart Rhythm. 13:830-835 |
| ISSN: | 1547-5271 |
| Popis: | Background Focal impulse and rotor modulation (FIRM)-guided ablation targets sites that are thought to sustain atrial fibrillation (AF). Objective The purpose of this study was to evaluate the acute and mid-term outcomes of FIRM-guided only ablation in patients with nonparoxysmal AF. Methods We prospectively enrolled patients with persistent and long-standing persistent (LSP) AF at three centers to undergo FIRM-guided only ablation. We evaluated acute procedural success (defined as AF termination, organization, or ≥10% slowing), safety (incidence of periprocedural complications), and long-term success (single-procedure freedom from atrial tachycardia [AT]/AF off antiarrhythmic drugs [AAD] after a 2-month blanking period). Results Twenty-nine patients with persistent (N = 20) and LSP (N = 9) AF underwent FIRM mapping. Rotors were presents in all patients, with a mean of 4 ± 1.2 per patient (62% were left atrial); 1 focal impulse was identified. All sources were successfully ablated, and overall acute success rate was 41% (0 AF termination, 2 AF slowing, 10 AF organization). There were no major procedure-related adverse events. After a mean 5.7 months of follow-up, single-procedure freedom from AT/AF without AADs was 17%. Conclusion In nonparoxysmal AF patients, targeted ablation of FIRM-identified rotors is not effective in obtaining AF termination, organization, or slowing during the procedure. After mid-term follow-up, the strategy of ablating FIRM-identified rotors alone did not prevent recurrence from AT/AF. |
| Databáze: | OpenAIRE |
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