Effect of ablation at high-dominant frequency sites overlapping with low-voltage areas after pulmonary vein isolation of nonparoxysmal atrial fibrillation.
atrial fibrillation
catheter ablation
dominant frequencies
low-voltage areas
pulmonary vein isolation
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
25
04
2019
revised:
14
07
2019
accepted:
17
07
2019
pubmed:
31
7
2019
medline:
6
10
2020
entrez:
31
7
2019
Statut:
ppublish
Résumé
The relationship between high-dominant frequency (DF) sites and low-voltage areas (LVAs) in nonparoxysmal atrial fibrillation (AF) patients still remains unknown. This study aimed to evaluate the effect of ablation at high-DF sites overlapping with LVAs after pulmonary vein ablation (PVI) of nonparoxysmal AF. A total of 128 consecutive nonparoxysmal patients with atrial fibrillation (53 persistent AF) were retrospectively investigated. The patients with AF were divided into two groups: patients with circumferential PVI alone (PVI group, n = 57) and those with PVI followed by a DF-based ablation (DF group, n = 71). The patient characteristics did not significantly differ between the two groups. However, the LVA ( < 0.5 mV)/left atrial (LA) surface was significantly greater in the DF than the PVI group (22% vs 16%, P = .02). The total max-DF sites overlapping with LVAs in the LA were significantly greater in the DF than the PVI group (91% vs 10%, P = .001). The atrial arrhythmia freedom on antiarrhythmic drugs in the DF group was significantly greater than that in the PVI group during 10.0 ± 3.2 months of follow-up (83.1% vs 64.9%, log-rank test P = .021). The event-free survival in the PVI group decreased according to the LVA extent while it was > 80% in the DF group. The event-free survival in patients with AF especially with extensive LVAs ( ≥ 30%) in the DF group was significantly greater than that in the PVI group (81.0% vs 45.5%, log-rank test P = .035). High-DF sites overlapping with LVAs after the PVI may be potential selective targets for modification of atrial substrates in nonparoxysmal AF patients.
Sections du résumé
BACKGROUND
The relationship between high-dominant frequency (DF) sites and low-voltage areas (LVAs) in nonparoxysmal atrial fibrillation (AF) patients still remains unknown.
OBJECTIVE
This study aimed to evaluate the effect of ablation at high-DF sites overlapping with LVAs after pulmonary vein ablation (PVI) of nonparoxysmal AF.
METHODS
A total of 128 consecutive nonparoxysmal patients with atrial fibrillation (53 persistent AF) were retrospectively investigated. The patients with AF were divided into two groups: patients with circumferential PVI alone (PVI group, n = 57) and those with PVI followed by a DF-based ablation (DF group, n = 71).
RESULTS
The patient characteristics did not significantly differ between the two groups. However, the LVA ( < 0.5 mV)/left atrial (LA) surface was significantly greater in the DF than the PVI group (22% vs 16%, P = .02). The total max-DF sites overlapping with LVAs in the LA were significantly greater in the DF than the PVI group (91% vs 10%, P = .001). The atrial arrhythmia freedom on antiarrhythmic drugs in the DF group was significantly greater than that in the PVI group during 10.0 ± 3.2 months of follow-up (83.1% vs 64.9%, log-rank test P = .021). The event-free survival in the PVI group decreased according to the LVA extent while it was > 80% in the DF group. The event-free survival in patients with AF especially with extensive LVAs ( ≥ 30%) in the DF group was significantly greater than that in the PVI group (81.0% vs 45.5%, log-rank test P = .035).
CONCLUSIONS
High-DF sites overlapping with LVAs after the PVI may be potential selective targets for modification of atrial substrates in nonparoxysmal AF patients.
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1850-1859Informations de copyright
© 2019 Wiley Periodicals, Inc.