5-Year Outcome of Pulmonary Vein Isolation by Loss of Pace Capture on the Ablation Line Versus Electrical Circumferential Pulmonary Vein Isolation
Standard
5-Year Outcome of Pulmonary Vein Isolation by Loss of Pace Capture on the Ablation Line Versus Electrical Circumferential Pulmonary Vein Isolation. / Moser, Julia; Sultan, Arian; Lüker, Jakob; Servatius, Helge; Salzbrunn, Tim; Altenburg, Manuel; Schäffer, Benjamin; Schreiber, Doreen; Akbulak, Ruken Ö; Vogler, Julia; Hoffmann, Boris A; Willems, Stephan; Steven, Daniel.
In: JACC-CLIN ELECTROPHY, Vol. 3, No. 11, 11.2017, p. 1262-1271.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - 5-Year Outcome of Pulmonary Vein Isolation by Loss of Pace Capture on the Ablation Line Versus Electrical Circumferential Pulmonary Vein Isolation
AU - Moser, Julia
AU - Sultan, Arian
AU - Lüker, Jakob
AU - Servatius, Helge
AU - Salzbrunn, Tim
AU - Altenburg, Manuel
AU - Schäffer, Benjamin
AU - Schreiber, Doreen
AU - Akbulak, Ruken Ö
AU - Vogler, Julia
AU - Hoffmann, Boris A
AU - Willems, Stephan
AU - Steven, Daniel
N1 - Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2017/11
Y1 - 2017/11
N2 - OBJECTIVES: This study sought to compare long-term arrhythmia-free survival between electrical circumferential pulmonary vein isolation (PVI) and PVI with the endpoint of unexcitability along the ablation line.BACKGROUND: PVI is the standard ablation strategy of paroxysmal atrial fibrillation, although arrhythmia recurrence in long-term follow-up (FU) is high. The endpoint of unexcitability along the ablation line results in decreased arrhythmia recurrence compared to electrical PVI in 1-year FU.METHODS: Seventy-four consecutive patients (age 62.5 ± 10.6 years; 70.3% male) with de novo paroxysmal atrial fibrillation who were initially included in our randomized trial and underwent catheter ablation at our institution were analyzed. Patients who were randomized to either a conventional group (PVI, guided by circumferential catheter signals) or a pace-guided group (PG, anatomical ablation line encircling, ablation until loss of pace capture at 10 V, 2-ms pulse width on the ablation line) underwent long-term FU. The primary endpoint was recurrence of any atrial fibrillation or atrial tachycardia after a blanking period of 3 months.RESULTS: Sixty-nine patients completed a mean FU period of 5.14 ± 0.98 years. Arrhythmia-free survival without antiarrhythmic drug therapy was significantly higher in the PG group (71.05% vs. 25.81%, p = 0.002). Furthermore, multiple procedure success (1.29 ± 0.61 procedures in PG vs. 1.97 ± 1.06 procedures in conventional group, p < 0.001) was higher in the PG group compared to the conventional group (89.47% vs. 58.06%, p = 0.005).CONCLUSIONS: The endpoint of unexcitability along the PVI line improves success rates, resulting in a significant reduction of exposure to invasive procedures in 5-year FU.
AB - OBJECTIVES: This study sought to compare long-term arrhythmia-free survival between electrical circumferential pulmonary vein isolation (PVI) and PVI with the endpoint of unexcitability along the ablation line.BACKGROUND: PVI is the standard ablation strategy of paroxysmal atrial fibrillation, although arrhythmia recurrence in long-term follow-up (FU) is high. The endpoint of unexcitability along the ablation line results in decreased arrhythmia recurrence compared to electrical PVI in 1-year FU.METHODS: Seventy-four consecutive patients (age 62.5 ± 10.6 years; 70.3% male) with de novo paroxysmal atrial fibrillation who were initially included in our randomized trial and underwent catheter ablation at our institution were analyzed. Patients who were randomized to either a conventional group (PVI, guided by circumferential catheter signals) or a pace-guided group (PG, anatomical ablation line encircling, ablation until loss of pace capture at 10 V, 2-ms pulse width on the ablation line) underwent long-term FU. The primary endpoint was recurrence of any atrial fibrillation or atrial tachycardia after a blanking period of 3 months.RESULTS: Sixty-nine patients completed a mean FU period of 5.14 ± 0.98 years. Arrhythmia-free survival without antiarrhythmic drug therapy was significantly higher in the PG group (71.05% vs. 25.81%, p = 0.002). Furthermore, multiple procedure success (1.29 ± 0.61 procedures in PG vs. 1.97 ± 1.06 procedures in conventional group, p < 0.001) was higher in the PG group compared to the conventional group (89.47% vs. 58.06%, p = 0.005).CONCLUSIONS: The endpoint of unexcitability along the PVI line improves success rates, resulting in a significant reduction of exposure to invasive procedures in 5-year FU.
KW - Aged
KW - Atrial Fibrillation/physiopathology
KW - Cardiac Pacing, Artificial/methods
KW - Catheter Ablation/instrumentation
KW - Electric Stimulation Therapy/methods
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Pulmonary Veins/physiology
KW - Recurrence
KW - Treatment Outcome
U2 - 10.1016/j.jacep.2017.04.019
DO - 10.1016/j.jacep.2017.04.019
M3 - SCORING: Journal article
C2 - 29759622
VL - 3
SP - 1262
EP - 1271
JO - JACC-CLIN ELECTROPHY
JF - JACC-CLIN ELECTROPHY
SN - 2405-500X
IS - 11
ER -