Hybrid epicardial-endocardial ablation for long-standing persistent atrial fibrillation: A subanalysis of the CONVERGE Trial.
Antiarrhythmic drug
Endocardial ablation
Epicardial
Hybrid ablation
Long-standing persistent atrial fibrillation
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
entrez:
6
3
2023
pubmed:
7
3
2023
medline:
7
3
2023
Statut:
epublish
Résumé
Favorable clinical outcomes are difficult to achieve in long-standing persistent atrial fibrillation (LSPAF) with catheter ablation (CA). The CONVERGE (Convergence of Epicardial and Endocardial Ablation for the Treatment of Symptomatic Persistent Atrial FIbrillation) trial evaluated the effectiveness of hybrid convergent (HC) ablation vs endocardial CA. The study sought to evaluate the safety and effectiveness of HC vs CA in the LSPAF subgroup from the CONVERGE trial. The CONVERGE trial was a prospective, multicenter, randomized trial that enrolled 153 patients at 27 sites. A post hoc analysis was performed on LSPAF patients. The primary effectiveness was freedom from atrial arrhythmias off new or increased dose of previously failed or intolerant antiarrhythmic drugs (AADs) through 12 months. The primary safety endpoint was major adverse event incidence through 30 days with HC. Key secondary effectiveness measures included (1) percent of patients achieving ≥90% AF burden reduction vs baseline and (2) AF freedom. Sixty-five patients (42.5% of total enrollment) had LSPAF; 38 in HC and 27 in CA. Primary effectiveness was 65.8% (95% confidence interval [CI] 50.7%-80.9%) with HC vs 37.0% (95% CI 5.1%-52.4%) with CA ( Post hoc analysis demonstrated effectiveness and acceptable safety of HC compared with CA in LSPAF.
Sections du résumé
Background
UNASSIGNED
Favorable clinical outcomes are difficult to achieve in long-standing persistent atrial fibrillation (LSPAF) with catheter ablation (CA). The CONVERGE (Convergence of Epicardial and Endocardial Ablation for the Treatment of Symptomatic Persistent Atrial FIbrillation) trial evaluated the effectiveness of hybrid convergent (HC) ablation vs endocardial CA.
Objective
UNASSIGNED
The study sought to evaluate the safety and effectiveness of HC vs CA in the LSPAF subgroup from the CONVERGE trial.
Methods
UNASSIGNED
The CONVERGE trial was a prospective, multicenter, randomized trial that enrolled 153 patients at 27 sites. A post hoc analysis was performed on LSPAF patients. The primary effectiveness was freedom from atrial arrhythmias off new or increased dose of previously failed or intolerant antiarrhythmic drugs (AADs) through 12 months. The primary safety endpoint was major adverse event incidence through 30 days with HC. Key secondary effectiveness measures included (1) percent of patients achieving ≥90% AF burden reduction vs baseline and (2) AF freedom.
Results
UNASSIGNED
Sixty-five patients (42.5% of total enrollment) had LSPAF; 38 in HC and 27 in CA. Primary effectiveness was 65.8% (95% confidence interval [CI] 50.7%-80.9%) with HC vs 37.0% (95% CI 5.1%-52.4%) with CA (
Conclusion
UNASSIGNED
Post hoc analysis demonstrated effectiveness and acceptable safety of HC compared with CA in LSPAF.
Identifiants
pubmed: 36873309
doi: 10.1016/j.hroo.2022.11.007
pii: S2666-5018(22)00343-9
pmc: PMC9975017
doi:
Types de publication
Journal Article
Langues
eng
Pagination
111-118Informations de copyright
© 2022 Heart Rhythm Society. Published by Elsevier Inc.
Références
JAMA. 2020 Oct 27;324(16):1620-1628
pubmed: 33107945
N Engl J Med. 2015 May 7;372(19):1812-22
pubmed: 25946280
Heart Surg Forum. 2010 Oct;13(5):E317-21
pubmed: 20961832
Heart Rhythm. 2010 Jun;7(6):835-46
pubmed: 20206320
Heart Rhythm. 2016 Jan;13(1):132-40
pubmed: 26277862
Heart Rhythm. 2020 Oct;17(10):1740-1744
pubmed: 32389682
JACC Clin Electrophysiol. 2020 Aug;6(8):958-969
pubmed: 32819531
Circ Arrhythm Electrophysiol. 2020 Dec;13(12):e009288
pubmed: 33185144
J Am Coll Cardiol. 2017 Mar 14;69(10):1257-1269
pubmed: 28279292
Arrhythm Electrophysiol Rev. 2020 Aug;9(2):88-96
pubmed: 32983530
Int J Cardiol. 2020 Mar 15;303:49-53
pubmed: 32063280
Circ Arrhythm Electrophysiol. 2019 Aug;12(8):e007005
pubmed: 31401853
J Am Coll Cardiol. 2012 Nov 6;60(19):1921-9
pubmed: 23062545
Heart Rhythm. 2017 Oct;14(10):e275-e444
pubmed: 28506916
J Cardiovasc Electrophysiol. 2016 May;27(5):524-30
pubmed: 26766149
JACC Clin Electrophysiol. 2021 Feb;7(2):187-196
pubmed: 33602399
Innovations (Phila). 2011 Jul;6(4):243-7
pubmed: 22437982
J Cardiovasc Electrophysiol. 2021 Oct;32(10):2884-2894
pubmed: 34041815
Heart Rhythm. 2021 Feb;18(2):303-312
pubmed: 33045430
J Thorac Cardiovasc Surg. 2022 Aug;164(2):519-527.e4
pubmed: 33129501
Am Heart J. 2020 Jun;224:182-191
pubmed: 32416333
J Cardiovasc Electrophysiol. 2020 Jun;31(6):1394-1402
pubmed: 32270562
Ann Thorac Surg. 2015 Nov;100(5):1541-6; discussion 1547-8
pubmed: 26387721
Circ Arrhythm Electrophysiol. 2020 Aug;13(8):e008512
pubmed: 32634027
Heart Rhythm. 2020 Nov;17(11):1841-1847
pubmed: 32590151