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Lack of prognostic value of atrial arrhythmia inducibility and change in inducibility status after catheter ablation of atrial fibrillation.
- Source :
-
Heart rhythm [Heart Rhythm] 2018 May; Vol. 15 (5), pp. 660-665. Date of Electronic Publication: 2017 Oct 19. - Publication Year :
- 2018
-
Abstract
- Background: Previous studies have suggested a role of atrial arrhythmia inducibility as an endpoint of catheter ablation of atrial fibrillation (AF). The prognostic value of noninducibility after ablation and of a change in inducibility status has not been investigated in large studies.<br />Objective: The purpose of this study was to evaluate the prognostic role of noninducibility and of a change in inducibility status after ablation of AF.<br />Methods: We studied 305 consecutive patients with AF (66% paroxysmal) undergoing antral pulmonary vein (PV) isolation plus non-PV triggers ablation. All patients underwent a standardized induction protocol before and after ablation from the coronary sinus and right atrium: 15-beat burst pacing at 250 ms and decrementing to 180 ms (up to 20 μg/min isoproterenol). Inducibility was defined as any sustained AF or organized atrial tachycardia (AT) lasting >2 minutes.<br />Results: A total of 197 patients (65%) had inducible AF/AT at baseline compared to 118 (39%) after ablation. One hundred seven patients (57%) changed their inducibility status from inducible preablation to noninducible postablation. After 19 ± 7 months of follow-up, 212 patients (70%) remained free from any recurrent AF/AT. Noninducibility of AF/AT postablation (log-rank P = .236) or change in inducibility status (log-rank P = .429) was not associated with reduced risk of recurrent AF/AT. Results were consistent across the paroxysmal and nonparoxysmal subgroups.<br />Conclusion: Noninducibility of atrial arrhythmia or change in inducibility status after PV isolation and non-PV trigger ablation is not associated with long-term freedom from recurrent arrhythmia and should not be used as an ablation endpoint or to support the appropriateness of additional ablation lesion sets.<br /> (Copyright © 2017. Published by Elsevier Inc.)
- Subjects :
- Atrial Fibrillation diagnosis
Atrial Fibrillation physiopathology
Catheter Ablation methods
Endosonography
Female
Follow-Up Studies
Heart Conduction System surgery
Humans
Male
Middle Aged
Prognosis
Pulmonary Veins diagnostic imaging
Recurrence
Retrospective Studies
Treatment Outcome
Atrial Fibrillation surgery
Electrophysiologic Techniques, Cardiac
Heart Conduction System physiopathology
Pulmonary Veins surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1556-3871
- Volume :
- 15
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Heart rhythm
- Publication Type :
- Academic Journal
- Accession number :
- 29056544
- Full Text :
- https://doi.org/10.1016/j.hrthm.2017.10.023