Efficacy of catheter ablation of focal sources in persistent atrial fibrillation.
Abstract: Introduction: Recent studies suggest that atrial fibrillation (AF) is maintained by electrical activity arising from focal sources. We sought to test whether catheter ablation that targets focal sources can improve on current ablation protocols for persistent AF. Methods and results: In pa...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 29; no. 4; pp. 559 - 566 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129078237&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129078237 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Apr2018 vid: 29 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 129078237 129078237 129078237 10.1111/jce.13415 129078237 ppf: 559 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Efficacy of catheter ablation of focal sources in persistent atrial fibrillation. aug: au: Takahashi, Yoshihide Yamashita, Syu Suzuki, Masahito Yabe, Kento Hirao, Kenzo affil: Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan sug: subj: Catheter Ablation Clinical Effectiveness Atrial Fibrillation Surgery Human Descriptive Statistics Data Analysis Software Confidence Intervals Cox Proportional Hazards Model Male Female Middle Age Aged Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Abstract: Introduction: Recent studies suggest that atrial fibrillation (AF) is maintained by electrical activity arising from focal sources. We sought to test whether catheter ablation that targets focal sources can improve on current ablation protocols for persistent AF. Methods and results: In patients with persistent AF whose AF did not terminate with pulmonary vein (PV) isolation, the left atrium was mapped with a 20‐pole high‐density mapping catheter using CARTO®3 navigation. If a site demonstrated centrifugal activation over at least three consecutive cycles, it was deemed a focal source and ablated. If AF remained, defragmentation was performed until AF was terminated. Freedom from atrial tachyarrhythmia was compared between the study patients and propensity score matched historical controls who had undergone conventional stepwise ablation. Of the 68 study patients, 2.9 ± 1.9 focal sources were identified in 60 patients. Focal sources displayed transient centrifugal activation patterns for a median of six consecutive cycles. Total radiofrequency duration was shorter in the study group (62 ± 16 minutes vs. 75 ± 24 minutes, P = 0.0003). During a 1‐year follow‐up period, 39 (57%) and 26 (38%) patients were free from atrial tachyarrhythmias in the absence of antiarrhythmic drugs in the study and control groups, respectively (hazard ratio: 1.85, 95% confidence interval: 1.17–2.96, P = 0.009). Improvement of clinical outcome was mainly driven by a decrease in recurrence of atrial tachycardia in the study patients (22% vs. 40%, P = 0.047). Conclusion: The results of this study suggest that focal sources are appropriate ablation targets in addition to the PVs in persistent AF. pubtype: Academic Journal doctype: diagnostic images research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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