Comparison of ablation outcomes of the second ablation procedure for recurrent atrial fibrillation using an ultra-high-resolution mapping system and conventional mappings system.
atrial fibrillation
repeat ablation procedure
ultra-high-resolution mapping system
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
25
05
2019
revised:
26
07
2019
accepted:
07
08
2019
pubmed:
14
8
2019
medline:
18
2
2020
entrez:
14
8
2019
Statut:
ppublish
Résumé
The utility of an ultra-high-resolution electroanatomical mapping system (UHR-EAM, Rhythmia) for repeat atrial fibrillation (AF) ablation has not been evaluated. A second AF ablation procedure performed using UHR-EAM may demonstrate different outcomes compared with that using a conventional electroanatomical mapping system (C-EAM, CARTO3). This observational study enrolled consecutive patients who underwent a second AF ablation procedure using UHR-EAM (n = 103) and C-EAM (n = 153). The second ablation procedure included re-isolation of reconnected pulmonary veins (PVs) and elimination of clinical or induced non-PV AF triggers and atrial tachycardia (AT). Other empirical ablations were additionally conducted at the discretion of the operators. Re-isolation of PVs was achieved in 196 patients who had ≥1 left atrial-PV reconnection. The elimination rate of AT was higher in the UHR-EAM group than the C-EAM group (87% vs 65%, P = .040), while that of non-PV AF triggers was similar (63% vs 63%, P = 1.00). The UHR-EAM demonstrated shorter radiofrequency application time (21.8 ± 16.8 vs 28.0 ± 21.3 minutes, P = .017), but longer fluoroscopic time (26.2 ± 12.6 vs 21.4 ± 9.3 minutes, P = .0001). No severe complication developed. The total 1-year AF/AT-free survival rates were similar between the two groups (off AADs, 59.2% vs 56.2%, P = .62; on AADs, 65.0% vs 69.3%, P = .49). The efficacy and safety outcomes of repeat AF ablation using UHR-EAM was comparable to those using C-EAM.
Sections du résumé
BACKGROUND
BACKGROUND
The utility of an ultra-high-resolution electroanatomical mapping system (UHR-EAM, Rhythmia) for repeat atrial fibrillation (AF) ablation has not been evaluated.
HYPOTHESIS
OBJECTIVE
A second AF ablation procedure performed using UHR-EAM may demonstrate different outcomes compared with that using a conventional electroanatomical mapping system (C-EAM, CARTO3).
METHOD
METHODS
This observational study enrolled consecutive patients who underwent a second AF ablation procedure using UHR-EAM (n = 103) and C-EAM (n = 153). The second ablation procedure included re-isolation of reconnected pulmonary veins (PVs) and elimination of clinical or induced non-PV AF triggers and atrial tachycardia (AT). Other empirical ablations were additionally conducted at the discretion of the operators.
RESULTS
RESULTS
Re-isolation of PVs was achieved in 196 patients who had ≥1 left atrial-PV reconnection. The elimination rate of AT was higher in the UHR-EAM group than the C-EAM group (87% vs 65%, P = .040), while that of non-PV AF triggers was similar (63% vs 63%, P = 1.00). The UHR-EAM demonstrated shorter radiofrequency application time (21.8 ± 16.8 vs 28.0 ± 21.3 minutes, P = .017), but longer fluoroscopic time (26.2 ± 12.6 vs 21.4 ± 9.3 minutes, P = .0001). No severe complication developed. The total 1-year AF/AT-free survival rates were similar between the two groups (off AADs, 59.2% vs 56.2%, P = .62; on AADs, 65.0% vs 69.3%, P = .49).
CONCLUSION
CONCLUSIONS
The efficacy and safety outcomes of repeat AF ablation using UHR-EAM was comparable to those using C-EAM.
Identifiants
pubmed: 31407347
doi: 10.1002/clc.23248
pmc: PMC6788574
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
966-973Informations de copyright
© 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc.
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