Optimal substrate modification strategies using catheter ablation in patients with persistent atrial fibrillation: 3‐year follow‐up outcomes
| Autor: | Chen Lin, Men Tzung Lo, Ta Chuan Tuan, Yun Yu Chen, Chih Min Liu, Cheng I. Wu, Chin Yu Lin, Chye Gen Chin, Yu Feng Hu, Shih Ann Chen, Jennifer Jeanne B. Vicera, Li Wei Lo, Tze Fan Chao, Fa Po Chung, Isaiah C. Lugtu, Yenn Jiang Lin, Jo Nan Liao, Yu Cheng Hsieh, Chun Chao Chen, Shih Lin Chang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Catheter ablation similarity index substrate 030204 cardiovascular system & hematology Pulmonary vein 03 medical and health sciences 0302 clinical medicine Recurrence Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Sinus rhythm In patient 030212 general & internal medicine Substrate modification Atrial tachycardia pulmonary vein isolation business.industry Atrial fibrillation Original Articles atrial tachycardia medicine.disease Ablation persistent atrial fibrillation Treatment Outcome Pulmonary Veins Ablation of Atrial Arrhythmias Cardiology Catheter Ablation Original Article phase map medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Journal of Cardiovascular Electrophysiology |
| ISSN: | 1540-8167 1045-3873 |
| Popis: | Objectives This study aimed to assess the comparative efficacy of 4 ablation strategies on the incidence rates of freedom from atrial fibrillation (AF) or atrial tachycardia (AT) through a 3-year follow-up in patients with persistent AF. Background The optimal substrate modification strategies using catheter ablation for patients with persistent AF remain unclear. Methods Patients with persistent AF were enrolled consecutively to undergo each of 4 ablation strategies: (a) Group 1 (Gp 1, n=69), pulmonary vein isolation (PVI) plus rotor ablation assisted by similarity index and phase mapping; (b) Gp 2 (n=75), PVI plus linear ablations at the left atrium; (c) Gp 3 (n=42), PVI plus elimination of complex fractionated atrial electrograms; (d) Gp 4 (n=67), PVI only. Potential confounders were adjusted via a multivariate survival parametric model. Results Baseline characteristics were similar across the 4 groups. At a follow-up period of 34.9±38.6 months, patients in Gp 1 showed the highest rate of freedom from AF compared with the other 3 groups (p=0.002), while patients in Gp 3 and 4 showed lower rates of freedom from AT than those of the other two groups (p=0.006). Independent predictors of recurrence of AF were the ablation strategy (p=0.002) and left atrial diameter (LAD) (p=0.01). Conclusion In patients with persistent AF, a substrate modification strategy using rotor ablation assisted by similarity index and phase mapping provided a benefit for maintaining sinus rhythm compared to the other strategies. Both ablation strategy and baseline LAD predicted the 3-year outcomes of freedom from AT/AF This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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