Importance of Sinus Rhythm as Endpoint of Persistent Atrial Fibrillation Ablation

被引:40
作者
Ammar, Sonia [1 ]
Hessling, Gabriele [1 ]
Reents, Tilko [1 ]
Paulik, Maria [1 ]
Fichtner, Stephanie [1 ]
Schoen, Patrick [1 ]
Dillier, Roger [1 ]
Kathan, Susanne [1 ]
Jilek, Clemens [1 ]
Kolb, Christof [1 ]
Haller, Bernhard [2 ]
Deisenhofer, Isabel [1 ]
机构
[1] Deutsch Herzzentrum Munich, D-80636 Munich, Germany
[2] Tech Univ Munich, Inst Stat & Epidemiol, D-80290 Munich, Germany
关键词
acute termination; atrial fibrillation; catheter ablation; complex fractionated atrial electrograms; pulmonary vein isolation; PULMONARY VEIN ISOLATION; CATHETER ABLATION; SUBSTRATE MODIFICATION; STEPWISE ABLATION; LINEAR ABLATION; FOLLOW-UP; TERMINATION; ELECTROGRAM; SUCCESS; SITES;
D O I
10.1111/jce.12045
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Endpoint of Persistent AF Ablation. Background: The endpoint of persistent atrial fibrillation (AF) ablation is still a matter of debate. The purpose of this study was to evaluate if sinus rhythm (SR) as endpoint of persistent AF ablation has a better long-term outcome compared to atrial tachycardia (AT) or AF at the end of the procedure. Methods and Results: Between 2008 and 2011, 191 consecutive patients undergoing de novo catheter ablation for symptomatic persistent and long-standing persistent AF using a sequential ablation approach (including pulmonary vein isolation, ablation of complex fractionated electrograms and linear lesions) were included in the study. According to the result at the end of ablation procedure, patients were classified into 3 groups: patients with termination of AF into SR (Group 1, n = 62), patients with AT undergoing cardioversion (CV) (Group 2, n = 47), or patients with AF undergoing CV (Group 3, n = 82). The primary endpoint was freedom from any atrial tachyarrhythmia off antiarrhythmic drugs at 12 months. At 12 months, estimated proportions of patients free from any arrhythmia recurrence were 42% for Group 1, 13% for Group 2, and 25% for Group 3 (P = 0.002). In a Cox regression analysis only termination into SR was associated with a lower risk of arrhythmia recurrence (HR: 0.62; P = 0.04). Conclusion: If SR is achieved as endpoint of persistent and long-standing persistent AF ablation using a sequential ablation approach it is associated with the highest long-term single procedure success rate compared to AT or AF at the end of the procedure. (J Cardiovasc Electrophysiol, Vol. 24, pp. 388-395, April 2013)
引用
收藏
页码:388 / 395
页数:8
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