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Optimal substrate modification strategies using catheter ablation in patients with persistent atrial fibrillation: 3‐year follow‐up outcomes
- Source :
- Journal of Cardiovascular Electrophysiology
- Publication Year :
- 2021
- Publisher :
- John Wiley and Sons Inc., 2021.
-
Abstract
- 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.
- Subjects :
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 15408167 and 10453873
- Volume :
- 32
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiovascular Electrophysiology
- Accession number :
- edsair.doi.dedup.....ee491cd517f3c52f563ca2f92283ae57