Impact of Atrial Fibrillation Termination Site and Termination Mode in Catheter Ablation on Arrhythmia Recurrence
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概要
- 論文の詳細を見る
Background: Although atrial fibrillation (AF) termination has been reported as a predictor of clinical outcome after persistent AF (PsAF) ablation, the relationship between AF termination site and mode and clinical outcome has not been fully evaluated. Methods and Results: A total of 135 patients (62±9 years) underwent their first ablation procedure for PsAF (76 longstanding PsAF). With an endpoint of AF termination, the ablation procedure was performed sequentially in the following order: pulmonary vein (PV) antrum isolation, and left atrial and right atrial substrate modification. AF termination was achieved in 69 patients (51%; 24 at the PV antrum, and 45 in the atrium; direct conversion to sinus rhythm in 21, and atrial tachycardia [AT] in 48). With a mean of 1.7±0.7 procedures/patient, 100 patients (74%) were free from atrial tachyarrhythmia (ATa) during a median of 15.0 months of follow-up. During the initial procedure, the AF termination site (atrium vs. PV antrum, hazard ratio [HR], 1.38; 95% confidence interval [CI]: 0.72–3.77; no termination vs. PV antrum, HR, 2.32; 95% CI: 1.26–6.30; P=0.023) and mode (AT vs. sinus rhythm, HR, 1.47; 95% CI: 0.77–4.01; no termination vs. sinus rhythm, HR, 2.38; 95% CI: 1.26–6.46; P=0.017) were independent predictors of ATa recurrence after the last ablation procedure. Conclusions: The site and mode of AF termination during the index ablation procedure predict ATa recurrence following multiple catheter ablation procedures for PsAF.
- 一般社団法人 日本循環器学会の論文
著者
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Hachiya Hitoshi
Cardiology Department, Yokosuka Kyosai General Hospital
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Miyazaki Shinsuke
Cardiovascular Center Yokosuka Kyosai Hospital
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Iesaka Yoshito
Cardiology Division Cardiovascular Center Tsuchiura Kyodo Hospital
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Nakamura Hiroaki
Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
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Kusa Shigeki
Cardiovascular Center Yokosuka Kyosai Hospital
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HIRAO Kenzo
Heart Rhythm Center, Tokyo Medical and Dental University
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Taniguchi Hiroshi
Cardiovascular Center, Tsuchiura Kyodo Hospital
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Hachiya Hitoshi
Cardiovascular Center, Tsuchiura Kyodo Hospital
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Uchiyama Takashi
Cardiovascular Center, Tsuchiura Kyodo Hospital
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Kusa Shigeki
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital
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Uchiyama Takashi
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital
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Miyazaki Shinsuke
Cardiovascular Center, Tsuchiura Kyodo Hospital
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Miyazaki Shinsuke
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital
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Nakamura Hiroaki
Cardiovascular Center, Tsuchiura Kyodo Hospital
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HIRAO Kenzo
Heart Rhythm Center Tokyo Medical and Dental University
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TANIGUCHI Hiroshi
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital
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