Atrial Fibrillation Ablation Strategies for Paroxysmal Patients Randomized Comparison Between Different Techniques

被引：100

作者：

Di Biase, Luigi ^{[1
,2
]}

Elayi, Claude S. ^{[3
]}

Fahmy, Tamer S. ^{[12
]}

Martin, David O. ^{[4
]}

Ching, Chi Keong ^{[10
]}

Barrett, Conor ^{[13
]}

Bai, Rong

Patel, Dimpi ^{[1
]}

Khaykin, Yaariv ^{[6
]}

Hongo, Richard ^{[5
]}

Hao, Steven ^{[5
]}

Beheiry, Salwa ^{[5
]}

Pelargonio, Gemma ^{[7
]}

Dello Russo, Antonio ^{[7
]}

Casella, Michela ^{[7
]}

Santarelli, Pietro ^{[7
]}

Potenza, Domenico ^{[8
]}

Fanelli, Raffaele ^{[8
]}

Massaro, Raimondo ^{[8
]}

Wang, Paul ^{[9
]}

Al-Ahmad, Amin ^{[9
]}

Arruda, Mauricio ^{[11
]}

Themistoclakis, Sakis

Bonso, Aldo

Rossillo, Antonio

Raviele, Antonio

Schweikert, Robert A. ^{[14
]}

Burkhardt, David J. ^{[1
]}

Natale, Andrea ^{[1
,9
,11
]}

机构：

[1] St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, Austin, TX 78705 USA

[2] Univ Foggia, Dept Cardiol, Foggia, Italy

[3] Univ Kentucky, Gill Heart Inst, Div Cardiovasc Med, Lexington, KY USA

[4] Cleveland Clin, Cleveland, OH 44106 USA

[5] Sutter Pacific Heart Ctr, San Francisco, CA USA

[6] Southlake Reg Hlth Ctr, New Market, ON, Canada

[7] Catholic Univ, Rome, Italy

[8] Casa Sollievo Sofferenza, Foggia, Italy

[9] Stanford Univ, Palo Alto, CA 94304 USA

[10] Natl Heart Ctr Singapore Mistri Wing, Dept Cardiol, Singapore, Singapore

[11] Case Western Reserve Univ, Sch Med, Cleveland, OH USA

[12] Cairo Univ, Dept Crit Care Med, Cairo, Egypt

[13] Massachusetts Gen Hosp, Ctr Heart, Cardiac Arrhythmia Serv, Boston, MA 02114 USA

[14] Akron Gen Hosp, Akron, OH USA

来源：

CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY | 2009年 / 2卷 / 02期

关键词：

catheter ablation; paroxysmal atrial fibrillation; pulmonary vein antrum isolation; radiofrequency; randomized study; complex fractionated atrial electrograms or defragmentation; VEIN ANTRUM ISOLATION; PULMONARY VEIN; CATHETER ABLATION;

D O I：

10.1161/CIRCEP.108.798447

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-Whether different ablation strategies affect paroxysmal atrial fibrillation (AF) long-term freedom from AF/atrial tachyarrhythmia is unclear. We sought to compare the effect of 3 different ablation approaches on the long-term success in patients with paroxysmal AF Methods and Results-One hundred three consecutive patients with paroxysmal AF scheduled for ablation and presenting in the electrophysiology laboratory in AF were selected for this study. Patients were randomized to pulmonary vein antrum isolation (PVAI; n=35) versus biatrial ablation of the complex fractionated atrial electrograms (CFEs; n=34) versus PVAI followed by CFAEs (n=34). Patients were given event recorders and followed up at 3, 6, 9, 12, and 15 months postablation. There was no statistical significant difference between the groups in term of sex, age, AF duration, left atrial size, and ejection fraction. At I year follow-up, freedom from AF/atrial tachyarrhythmia was documented in 89% of patients in the PVAI group, 91% in the PVAI plus CFAEs group, and 23% in the CFAEs group (P<0.001) after a single procedure and with antiarrhythmic drugs. Conclusion-No difference in terms of success rate was seen between PVAI alone and PVAI associated with defragmentation. CFAEs ablation alone had the smallest impact on AF recurrences at 1-year follow-up. These results suggest that antral isolation is sufficient to treat most patients with paroxysmal AF. (Circ Arrhythmia Electrophysiol. 2009;2:113-119.)

引用

页码：113 / 119

页数：7

共 21 条

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