Treatment of pathophysiologic propagation outside of the pulmonary veins in retreatment of atrial fibrillation patients: RECOVER AF study
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Treatment of pathophysiologic propagation outside of the pulmonary veins in retreatment of atrial fibrillation patients: RECOVER AF study. / Betts, Timothy R; Good, Wilson W; Melki, Lea; Metzner, Andreas; Grace, Andrew; Verma, Atul; Murray, Stephen; James, Simon; Wong, Tom; Boersma, Lucas V A; Steven, Daniel; Sultan, Arian; Busch, Sonia; Neužil, Petr; de Asmundis, Carlo; Lee, Justin; Szili-Török, Tamás.
in: EUROPACE, Jahrgang 25, Nr. 5, euad097, 19.05.2023.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Treatment of pathophysiologic propagation outside of the pulmonary veins in retreatment of atrial fibrillation patients: RECOVER AF study
AU - Betts, Timothy R
AU - Good, Wilson W
AU - Melki, Lea
AU - Metzner, Andreas
AU - Grace, Andrew
AU - Verma, Atul
AU - Murray, Stephen
AU - James, Simon
AU - Wong, Tom
AU - Boersma, Lucas V A
AU - Steven, Daniel
AU - Sultan, Arian
AU - Busch, Sonia
AU - Neužil, Petr
AU - de Asmundis, Carlo
AU - Lee, Justin
AU - Szili-Török, Tamás
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/5/19
Y1 - 2023/5/19
N2 - AIMS: RECOVER AF evaluated the performance of whole-chamber non-contact charge-density mapping to guide the ablation of non-pulmonary vein (PV) targets in persistent atrial fibrillation (AF) patients following either a first or second failed procedure.METHODS AND RESULTS: RECOVER AF was a prospective, non-randomized trial that enrolled patients scheduled for a first or second ablation retreatment for recurrent AF. The PVs were assessed and re-isolated if necessary. The AF maps were used to guide the ablation of non-PV targets through elimination of pathologic conduction patterns (PCPs). Primary endpoint was freedom from AF on or off antiarrhythmic drugs (AADs) at 12 months. Patients undergoing retreatment with the AcQMap System (n = 103) were 76% AF-free at 12 months [67% after single procedure (SP)] on or off AADs (80% free from AF on AADs). Patients who had only received a pulmonary vein isolation (PVI) prior to study treatment of non-PV targets with the AcQMap System were 91% AF-free at 12 months (83% SP). No major adverse events were reported.CONCLUSION: Non-contact mapping can be used to target and guide the ablation of PCPs beyond the PVs in persistent AF patients returning for a first or second retreatment with 76% freedom from AF at 12 months. The AF freedom was particularly high, 91% (43/47), for patients enrolled having only a prior de novo PVI, and freedom from all atrial arrhythmias for this cohort was 74% (35/47). These early results are encouraging and suggest that guiding individualized targeted ablation of PCPs may therefore be advantageous to target at the earliest opportunity in patients with persistent AF.
AB - AIMS: RECOVER AF evaluated the performance of whole-chamber non-contact charge-density mapping to guide the ablation of non-pulmonary vein (PV) targets in persistent atrial fibrillation (AF) patients following either a first or second failed procedure.METHODS AND RESULTS: RECOVER AF was a prospective, non-randomized trial that enrolled patients scheduled for a first or second ablation retreatment for recurrent AF. The PVs were assessed and re-isolated if necessary. The AF maps were used to guide the ablation of non-PV targets through elimination of pathologic conduction patterns (PCPs). Primary endpoint was freedom from AF on or off antiarrhythmic drugs (AADs) at 12 months. Patients undergoing retreatment with the AcQMap System (n = 103) were 76% AF-free at 12 months [67% after single procedure (SP)] on or off AADs (80% free from AF on AADs). Patients who had only received a pulmonary vein isolation (PVI) prior to study treatment of non-PV targets with the AcQMap System were 91% AF-free at 12 months (83% SP). No major adverse events were reported.CONCLUSION: Non-contact mapping can be used to target and guide the ablation of PCPs beyond the PVs in persistent AF patients returning for a first or second retreatment with 76% freedom from AF at 12 months. The AF freedom was particularly high, 91% (43/47), for patients enrolled having only a prior de novo PVI, and freedom from all atrial arrhythmias for this cohort was 74% (35/47). These early results are encouraging and suggest that guiding individualized targeted ablation of PCPs may therefore be advantageous to target at the earliest opportunity in patients with persistent AF.
KW - Humans
KW - Atrial Fibrillation/diagnosis
KW - Prospective Studies
KW - Pulmonary Veins/surgery
KW - Retreatment
KW - Anti-Arrhythmia Agents
KW - Catheter Ablation/adverse effects
KW - Treatment Outcome
KW - Recurrence
U2 - 10.1093/europace/euad097
DO - 10.1093/europace/euad097
M3 - SCORING: Journal article
C2 - 37072340
VL - 25
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 5
M1 - euad097
ER -