Mechanisms of Early Recurrence after AF Ablation for Longstanding, Persistent AF
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概要
- 論文の詳細を見る
<B>Background:</B> A blanking period (BP) of two months is currently employed after AF ablation when reporting outcomes. However, mechanisms and implications of early recurrence (ER) within BP are not clear, and the theoretically optimal length of BP has been still debatable.<BR><B>Methods and Results:</B> Consecutive 206 patients (age: 62±9 years) with longstanding persistent AF (AF duration: 70±75 months, LA diameter: 47±5 mm) underwent the extensive PV isolation and anatomical linear ablation. ER within two months occurred in 115 patients (56%) at a mean of 9±1 days after the procedure, and 101 of the 115 patients underwent redo ablation procedure more than 2 month after the initial ablation session. In 74 patients, LA-PV reconnections were observed in at least one of the PVs (Group-PV), while no LA-PV reconnection was observed in the other 27 patients (Group-NPV). The time to the first ER after the initial session was significantly shorter in Group-NPV than in Group-PV (6±9 vs. 13±14 days; P<0.002). The incidence of late recurrence more than 2 months after the initial ablation session and before the redo session was higher in Group-PV than in Group-NPV [53/74 (72%) vs. 12/27 (44%); P<0.03].<BR><B>Conclusions:</B> The results of this study suggested that the mechanism of very ERs after initial session in patients without LA-PV reconnection in redo session might be acute influence from lesion inflammation, while that of later ERs after initial session in those with LA-PV reconnection in redo session may be PV firings.
著者
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Iesaka Yoshito
Tsuchiura Kyodo General Hospital
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Komatsu Yuki
Tsuchiura Kyodo Hospital
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Hishikari Keiichi
Tsuchiura Kyodo Hospital
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Taniguchi Hiroshi
Tsuchiura Kyodo Hospital
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Kusa Shigeki
Tsuchiura Kyodo Hospital
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Takayama Kei
Tsuchiura Kyodo Hospital
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Uchiyama Takashi
Tsuchiura Kyodo Hospital
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Otomo Kiyoshi
Tsuchiura Kyodo Hospital
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IESAKA Yoshito
Tsuchiura Kyndo General Hospital
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