Feasibility of catheter ablation in patients with persistent atrial fibrillation guided by fragmented late‐gadolinium enhancement areas

Autor:	Tomomi Akita, Yoshiaki Watanabe, Katsusuke Kyotani, Koji Fukuzawa, Mayumi Shigeru, Kunihiko Kiuchi, Kazutaka Nakasone, Hiroyuki Takahara, Noriyuki Negi, Yusuke Sonoda, Hideya Suehiro, Jun Sakai, Toshihiro Nakamura, Atsusuke Yatomi, Mitsuru Takami, hiroyuki oonishi, Makoto Takemoto, Atsushi K. Kono, Ken-ichi Hirata, Kyoko Yamamoto, Yu Izawa
Rok vydání:	2021
Předmět:	medicine.medical_specialty medicine.medical_treatment Contrast Media Gadolinium Catheter ablation 030204 cardiovascular system & hematology Pulmonary vein 03 medical and health sciences 0302 clinical medicine Recurrence Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Late gadolinium enhancement Computer Simulation In patient 030212 general & internal medicine Atrial tachycardia Aged medicine.diagnostic_test business.industry Magnetic resonance imaging Atrial fibrillation Middle Aged medicine.disease Ablation Treatment Outcome Pulmonary Veins Catheter Ablation Cardiology Feasibility Studies medicine.symptom Cardiology and Cardiovascular Medicine business
Zdroj:	Journal of Cardiovascular Electrophysiology. 32:1014-1023
ISSN:	1540-8167 1045-3873
DOI:	10.1111/jce.14925
Popis:	BACKGROUND: A computer simulation model has demonstrated that an atrial fibrillation (AF) driver can be attached to heterogeneous fibrosis assessed by late gadolinium enhancement magnetic resonance imaging (LGE-MRI). However, it has not been well elucidated in patients with persistent AF. The aim of this study was to investigate whether radiofrequency (RF) applications in the fragmented LGE area (FLA) could terminate AF or convert it to atrial tachycardia (AT) and improve the rhythm outcome. METHODS: A total of 31 consecutive persistent AF patients with FLAs were enrolled (FLA ablation group, mean age: 69 ± 8 years, mean left atrial diameter: 42 ± 6 mm). A favorable response was defined as direct AF termination or AT conversion during RF applications at the FLA. The rhythm outcome was compared between the FLA ablation group and FLA burden-matched pulmonary vein isolation (PVI) group. RESULTS: Favorable responses were found in 15 (48%) of 31 patients in the FLA group (AF termination in 7, AT conversion in 8 patients), but not in the PVI group. AF recurrence at 12 months follow-up was significantly less in the FLA ablation group than in the PVI group (4 [13%] vs. 12 [39%] of 31 patients, log-rank p=0.023). In patients with a favorable response, AT recurred in 1 (7%) of 15 patients but AF did not. CONCLUSIONS: FLA ablation could terminate AF or convert it to AT in half of the patients. No AF recurrence was documented in patients with a favorable response. This article is protected by copyright. All rights reserved.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a4a540b7dc9108cc9749b250db51fa2a https://doi.org/10.1111/jce.14925 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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