Efficacy of LGE‐MRI‐guided fibrosis ablation versus conventional catheter ablation of atrial fibrillation: The DECAAF II trial: Study design.
Introduction: Success rates of catheter ablation in persistent atrial fibrillation (AF) remain suboptimal. A better and more targeted ablation strategy is urgently needed to optimize outcomes of AF treatment. We sought to assess the safety and efficacy of targeting atrial fibrosis during ablation of...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 32; no. 4; pp. 916 - 925 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2021
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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=149664429&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149664429 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Apr2021 vid: 32 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 149664429 148999796 149664429 149664429 10.1111/jce.14957 149664429 ppf: 916 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Efficacy of LGE‐MRI‐guided fibrosis ablation versus conventional catheter ablation of atrial fibrillation: The DECAAF II trial: Study design. aug: au: Marrouche, Nassir F. Greene, Tom Dean, J. Michael Kholmovski, Eugene G. Boer, Leonie Morrison‐de Mansour, Moussa Calkins, Hugh Marchlinski, Francis Wilber, David Hindricks, Gerhard Mahnkopf, Christian Jais, Pierre Sanders, Prashanthan Brachmann, Johannes Bax, Jereon Dagher, Lilas Wazni, Oussama Akoum, Nazem affil: Department of Cardiology, Tulane University School of Medicine, New Orleans Louisiana,, USA sug: subj: Magnetic Resonance Imaging Methods Fibrosis Therapy Ablation Techniques Methods Catheter Ablation Atrial Fibrillation Therapy Patient Safety Treatment Outcomes Human Pulmonary Veins Surgery Smartphone Utilization Electrocardiography Secondary Analysis Descriptive Statistics Cox Proportional Hazards Model ab: Introduction: Success rates of catheter ablation in persistent atrial fibrillation (AF) remain suboptimal. A better and more targeted ablation strategy is urgently needed to optimize outcomes of AF treatment. We sought to assess the safety and efficacy of targeting atrial fibrosis during ablation of persistent AF patients in improving procedural outcomes. Methods: The DECAAF II trial (ClinicalTrials. gov identifier number NCT02529319) is a prospective, randomized, multicenter trial of patients with persistent AF. Patients with persistent AF undergoing a first‐time ablation procedure were randomized in a 1:1 fashion to receive conventional pulmonary vein isolation (PVI) ablation (Group 1) or PVI + fibrosis‐guided ablation (Group 2). Left atrial fibrosis and ablation induced scarring were defined by late gadolinium enhancement magnetic resonance imaging at baseline and at 3–12 months postablation, respectively. The primary endpoint is the recurrence of atrial arrhythmia postablation, including atrial fibrillation, atrial flutter, or atrial tachycardia after the 90‐day postablation blanking period. Patients were followed for a period of 12–18 months with a smartphone ECG Device (ECG Check Device, Cardiac Designs Inc.). With an anticipated enrollment of 900 patients, this study has an 80% power to detect a 26% reduction in the hazard ratio of the primary endpoint. Results and Conclusion: The DECAAF II trial is the first prospective, randomized, multicenter trial of patients with persistent AF using imaging defined atrial fibrosis as a treatment target. The trial will help define an optimal approach to catheter ablation of persistent AF, further our understanding of influencers of ablation lesion formation, and refine selection criteria for ablation based on atrial myopathy burden. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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