Impact of left atrial posterior wall isolation on arrhythmia outcomes in patients with atrial fibrillation undergoing repeat ablation.
Atrial fibrillation
Catheter ablation
Outcomes
Posterior wall
Repeat ablation
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
entrez:
20
10
2021
pubmed:
21
10
2021
medline:
21
10
2021
Statut:
epublish
Résumé
It remains unclear whether additional left atrial posterior wall isolation (LAPWI) beyond pulmonary vein reisolation (PVRI) is beneficial in atrial fibrillation (AF) patients undergoing repeat ablation. We sought to assess impact of LAPWI on arrhythmia outcomes in patients undergoing repeat AF ablation. All AF patients that underwent repeat ablation between January 2016 and December 2018 were included. Those undergoing PVRI only served as control, whereas those undergoing LAPWI (with or without PVRI) were the study group. Primary endpoint was freedom from atrial arrhythmias (AA) off antiarrhythmic drugs (AADs) at 1 year follow-up. Secondary endpoint was freedom from AA on/off AADs at 1 year follow-up. One hundred ninety-six patients (61% paroxysmal AF, 39% persistent AF) participated; 93 underwent PVRI and 103 underwent LAPWI±PVRI. Patients in the LAPWI group were older, had more hypertension and persistent AF, and had lower rates of PV reconnection (52.4% vs 100%, LAPWI did not improve freedom from atrial arrhythmias on or off AADs at 1 year beyond PVRI in AF patients undergoing repeat ablation. Differences in patient demographics and AF type may underlie the observed lack of benefit of LAPWI, and further study is warranted.
Sections du résumé
BACKGROUND
BACKGROUND
It remains unclear whether additional left atrial posterior wall isolation (LAPWI) beyond pulmonary vein reisolation (PVRI) is beneficial in atrial fibrillation (AF) patients undergoing repeat ablation.
OBJECTIVE
OBJECTIVE
We sought to assess impact of LAPWI on arrhythmia outcomes in patients undergoing repeat AF ablation.
METHODS
METHODS
All AF patients that underwent repeat ablation between January 2016 and December 2018 were included. Those undergoing PVRI only served as control, whereas those undergoing LAPWI (with or without PVRI) were the study group. Primary endpoint was freedom from atrial arrhythmias (AA) off antiarrhythmic drugs (AADs) at 1 year follow-up. Secondary endpoint was freedom from AA on/off AADs at 1 year follow-up.
RESULTS
RESULTS
One hundred ninety-six patients (61% paroxysmal AF, 39% persistent AF) participated; 93 underwent PVRI and 103 underwent LAPWI±PVRI. Patients in the LAPWI group were older, had more hypertension and persistent AF, and had lower rates of PV reconnection (52.4% vs 100%,
CONCLUSION
CONCLUSIONS
LAPWI did not improve freedom from atrial arrhythmias on or off AADs at 1 year beyond PVRI in AF patients undergoing repeat ablation. Differences in patient demographics and AF type may underlie the observed lack of benefit of LAPWI, and further study is warranted.
Identifiants
pubmed: 34667964
doi: 10.1016/j.hroo.2021.07.004
pii: S2666-5018(21)00121-5
pmc: PMC8505210
doi:
Types de publication
Journal Article
Langues
eng
Pagination
489-497Informations de copyright
© 2021 Heart Rhythm Society. Published by Elsevier Inc.
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