当前位置: 首页 > 详情页

Long-term follow-up of patients with paroxysmal atrial fibrillation and severe left atrial scarring: comparison between pulmonary vein antrum isolation only or pulmonary vein isolation combined with either scar homogenization or trigger ablation

文献详情

资源类型:

收录情况: ◇ SCIE

机构: [1]St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, 3000 N IH-35,Suite 720, Austin, TX 78705 USA; [2]Univ Texas Austin, Dell Med Sch, Dept Internal Med, Austin, TX 78712 USA; [3]Montefiore Hosp, Albert Einstein Coll Med, Dept Med Cardiol, Philadelphia, PA USA; [4]Calif Pacific Med Ctr, San Francisco, CA 94114 USA; [5]Hosp Univ Penn, Cardiovasc Div, Electrophysiol Sect, 3400 Spruce St, Philadelphia, PA 19104 USA; [6]Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China; [7]Univ Kentucky, Coll Med, Dept Cardiovasc Med, Lexington, KY USA; [8]Univ Kansas, Ctr Excellence AF & Complex Arrhythmias, Kansas City, KS USA; [9]Univ Miami Hosp, Dept Med Cardiol, Miami, FL USA; [10]Scripps Clin, San Diego, CA 92128 USA; [11]Stanford Univ, Div Cardiol, Palo Alto, CA 94304 USA
出处:
ISSN:

关键词: Paroxysmal atrial fibrillation Left atrial scar Scar homogenization Non-pulmonary vein triggers Pulmonary vein antrum isolation

摘要:
Aims Left atrial (LA) scarring, a consequence of cardiac fibrosis is a powerful predictor of procedure-outcome in atrial fibrillation (AF) patients undergoing catheter ablation. We sought to compare the long-term outcome in patients with paroxysmal AF (PAF) and severe LA scarring identified by 3D mapping, undergoing pulmonary vein isolation (PVAI) only or PVAI and the entire scar areas (scar homogenization) or PVAI+ ablation of the non-PV triggers. Methods and results Totally, 177 consecutive patients with PAF and severe LA scarring were included. Patients underwent PVAI only (n = 45, Group 1), PVAI+ scar homogenization (n = 66, Group 2) or PVAI+ ablation of non-PV triggers (n = 66, Group 3) based on operator's choice. Baseline characteristics were similar across the groups. After first procedure, all patients were followed-up for a minimum of 2 years. The success rate at the end of the follow-up was 18% (8 pts), 21% (14 pts), and 61% (40 pts) in Groups 1, 2, and 3, respectively. Cumulative probability of AF-free survival was significantly higher in Group 3 (overall log-rank P < 0.01, pairwise comparison 1 vs. 3 and 2 vs. 3 P <0.01). During repeat procedures, non-PV triggers were ablated in all. After average 1.5 procedures, the success rates were 28 (62%), 41 (62%), and 56 (85%) in Groups 1, 2, and 3, respectively (log-rank P < 0.001). Conclusion In patients with PAF and severe LA scarring, PVAI+ ablation of non-PV triggers is associated with significantly better long-term outcome than PVAI alone or PVAI+ scar homogenization.

语种:
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2016]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 心脏和心血管系统
JCR分区:
出版当年[2015]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

第一作者:
第一作者机构: [1]St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, 3000 N IH-35,Suite 720, Austin, TX 78705 USA; [2]Univ Texas Austin, Dell Med Sch, Dept Internal Med, Austin, TX 78712 USA;
通讯作者:
通讯机构: [1]St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, 3000 N IH-35,Suite 720, Austin, TX 78705 USA; [2]Univ Texas Austin, Dell Med Sch, Dept Internal Med, Austin, TX 78712 USA; [4]Calif Pacific Med Ctr, San Francisco, CA 94114 USA; [10]Scripps Clin, San Diego, CA 92128 USA; [11]Stanford Univ, Div Cardiol, Palo Alto, CA 94304 USA
推荐引用方式(GB/T 7714):
APA:
MLA:

资源点击量:16409 今日访问量:0 总访问量:869 更新日期:2025-01-01 建议使用谷歌、火狐浏览器 常见问题

版权所有©2020 首都医科大学宣武医院 技术支持:重庆聚合科技有限公司 地址:北京市西城区长椿街45号宣武医院