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Pulmonary vein antral isolation and nonpulmonary vein trigger ablation without additional substrate modification for treating longstanding persistent atrial fibrillation.

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE
    • بيانات النشر:
      Publication: Malden, MA : Blackwell
      Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990-
    • الموضوع:
      Catheter Ablation*/adverse effects; Atrial Fibrillation/*surgery ; Pulmonary Veins/*surgery; Aged ; Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/physiopathology ; Atrial Flutter/etiology ; Atrial Flutter/surgery ; Chi-Square Distribution ; Disease-Free Survival ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Pulmonary Veins/physiopathology ; Recurrence ; Reoperation ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome
    • نبذة مختصرة :
      Introduction: Effectiveness of antral pulmonary vein isolation (PVAI) and ablation of non-PV triggers (non-PVTA) in controlling longstanding persistent atrial fibrillation (AF) has not been reported. We sought to describe clinical outcomes with this ablation strategy in patients (pts) followed for at least 1 year.
      Methods: Two hundred pts underwent PVAI for longstanding persistent AF and were followed for recurrence. Thirty-three pts with <1-year follow-up and 37 pts with additional RF atrial ablation were excluded, leaving 130 pts for analysis.
      Results: All 130 pts (108 men, mean LA 4.7 ± 0.6 cm, mean AF duration of 38 ± 44 months) underwent PVAI with entrance/exit block. In addition, 24 pts (15 pts during the initial procedure and 9 additional pts at repeat ablations) had 40 non-PVTA, including 3 with AVNRT. During follow-up, atrial flutter (AFL) was noted in 7 (5%) pts. The AF-free survival after single procedure without antiarrhythmic drugs (AAD) was 38%. Repeat AF or AFL ablation was performed in 37 pts (28%) with PV reconnection uniformly identified (3.7 ± 0.5 veins/pt). During mean follow-up of 41.1 ± 23.8 months (range 12-103 months), 85/130 pts (65%) were in sinus rhythm with 65 pts (50%) off AAD, 20 pts (15%) on AAD. Additionally, 9 pts (7%) have had rare episodes of AF such that 72% of pts have had good long-term clinical outcome. Of the 36 pts with recurrent AF, 20 pts have not had a repeat procedure.
      Conclusions: PVAI with non-PVTA for longstanding persistent AF provides good long-term AF control in over 70% of patients with infrequent (5%) AFL. AAD therapy and repeat PVAI may be required for this optimal outcome.
      (© 2012 Wiley Periodicals, Inc.)
    • الرقم المعرف:
      0 (Anti-Arrhythmia Agents)
    • الموضوع:
      Date Created: 20120419 Date Completed: 20130129 Latest Revision: 20220408
    • الموضوع:
      20221213
    • الرقم المعرف:
      10.1111/j.1540-8167.2012.02307.x
    • الرقم المعرف:
      22509772