A failed catheter ablation of atrial fibrillation is associated with more advanced remodeling and reduced efficacy of further thoracoscopic ablation

Autor: Robin Wesselink, Mindy Vroomen, Ingrid Overeinder, Jolien Neefs, Nicoline W.E. van den Berg, Eva R. Meulendijks, Femke R. Piersma, Rushd F.M. Al-Shama, Tim A.C. de Vries, Tom E. Verstraelen, Justin Luermans, Bart Maesen, Carlo de Asmundis, Gian-Battista Chierchia, Mark La Meir, Laurent Pison, Wim Jan P. van Boven, Antoine H.G. Driessen, Joris R. de Groot
Přispěvatelé: Heartrhythmmanagement, Clinical sciences, Vascular surgery, Cardiac Surgery, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - H08 Experimental atrial fibrillation, MUMC+: MA Med Staf Artsass CTC (9)
Rok vydání: 2022
Předmět:
Zdroj: Revista espanola de cardiologia (English Edition). Elsevier Doyma
ISSN: 1885-5857
Popis: INTRODUCTION AND OBJECTIVES: Recent observations suggest that patients with a previous failed catheter ablation have an increased risk of atrial fibrillation (AF) recurrence after subsequent thoracoscopic AF ablation. We assessed the risk of AF recurrence in patients with a previous failed catheter ablation undergoing thoracoscopic ablation.METHODS: We included patients from 3 medical centers. To correct for potential heterogeneity, we performed propensity matching to compare AF freedom (freedom from any atrial tachyarrhythmia > 30 s during a 1-year follow-up). Left atrial appendage tissue was analyzed for collagen distribution.RESULTS: A total of 705 patients were included, and 183 had a previous failed catheter ablation. These patients had fewer risk factors for AF recurrence than ablation naïve controls: smaller indexed left atrial volume (40.9 ± 12.5 vs 43.0 ± 12.5 mL/m2, P = .048), less congestive heart failure (1.5% vs 8.9%, P = .001), and less persistent AF (52.2% vs 60.3%, P = .067). However, AF history duration was longer in patients with a previous failed catheter ablation (6.5 [4-10.5] vs 4 [2-8] years; P CONCLUSIONS: Patients with a prior failed catheter ablation had fewer risk factors for AF recurrence but more frequently had AF recurrence after thoracoscopic AF ablation than ablation naïve patients. This may in part be explained by more progressed, subclinical, atrial fibrosis formation.
Databáze: OpenAIRE
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