Role of inducibility and its dynamic change in the outcome of catheter ablation of atrial fibrillation: a single center prospective study
| Autor: | Thomas Gaspar, Daniela Husser, Gerhard Hindricks, Nikolaos Dagres, Y. Huo, Arash Arya, Angeliki Darma, Sait S Daneschnejad, Christopher Piorkowski, Philipp Sommer, Andreas Bollmann, Ulrike Wetzel |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Refractory period medicine.medical_treatment Action Potentials Catheter ablation 030204 cardiovascular system & hematology Single Center Pulmonary vein 03 medical and health sciences 0302 clinical medicine Heart Rate Predictive Value of Tests Recurrence Risk Factors Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans 030212 general & internal medicine Prospective Studies Prospective cohort study Atrial tachycardia business.industry Cardiac Pacing Artificial Atrial fibrillation Middle Aged Ablation medicine.disease Treatment Outcome Pulmonary Veins cardiovascular system Cardiology Catheter Ablation Female medicine.symptom Cardiology and Cardiovascular Medicine business Electrophysiologic Techniques Cardiac |
| Zdroj: | Journal of cardiovascular electrophysiologyREFERENCES. 31(3) |
| ISSN: | 1540-8167 |
| Popis: | Background The role of atrial arrhythmia inducibility as an endpoint of catheter ablation of atrial fibrillation (AF) has been a controversial subject in many studies. Our goal is to evaluate the significance of inducibility, the impact of multiple sites or protocols of stimulation or the change in inducibility status in a prospective study including patients with AF undergoing first catheter ablation. Methods We studied 170 consecutive patients with AF (62.9% paroxysmal) undergoing catheter ablation. All patients underwent two separate stimulation protocols before and after the ablation from the coronary sinus ostium and the left atrial appendage: burst pacing at 300, 250, 200 milliseconds (or until refractoriness) for 10 seconds and ramp decrementing from 300 to 200 milliseconds in increments of 10 milliseconds every three beats for 10 seconds. Inducibility was defined as any sustained AF or organized atrial tachycardia (AT) lasting >30 seconds. Results We had AF/AT inducibility in 55 patients at baseline compared to 36 following ablation. After a mean of 41, 3 months follow-up, 115 patients were free of AF. Inducibility before or after the ablation or change in inducibility status did not influence AF recurrence. There were no significant differences regarding paroxysmal or persistent patients with AF. Conclusions Non-inducibility of atrial arrhythmia or change in inducibility status following pulmonary vein (PV) isolation and substrate modification are not associated with long-term freedom from recurrent arrhythmia. Therefore, the use of induction of an endpoint in AF ablation is limited. |
| Databáze: | OpenAIRE |
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