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Gul EE, Boles U, Haseeb S, Hopman W, Michael KA, Simpson C, Abdollah H, Baranchuk A, Redfearn D, Glover B. Contact-Force Guided Pulmonary Vein Isolation does not Improve Success Rate in Persistent Atrial Fibrillation Patients and Severe Left Atrial Enlargement: A 12-month Follow-Up Study. J Atr Fibrillation 2018; 11:2060. [PMID: 30505381 DOI: 10.4022/jafib.2060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022]
Abstract
Background Catheter ablation is a cornerstone treatment strategy in atrial fibrillation (AF). Left atrial (LA) size is one of the contributors in development of AF recurrences. The impact of contact-forced (CF) guided catheter ablation on the success rate of persistent AF patients with severe enlarged LA has not been investigated yet. Methods Sixty-six patients with diagnosis of longstanding persistent AF undergoing catheter ablation were enrolled. All patients underwent a standard transthoracic echocardiography according to the guidelines. LA size was considered severely enlarged when LA diameter was ≥ 50 mm. CF catheter ablation with a Tacticath Quartz catheter (St Jude Medical, St. Paul, MN, USA) was used in all patients. Results The mean age was 61.9 ± 9.9 years, and LAD 47.8 ± 11.6 mm. Among 66 patients with persistent AF, 32 (48%) patients were diagnosed with AF recurrences. Twenty-eight (42%) patients had severely enlarged LA. The recurrence of AF was comparable in patients with and without severe enlarged LA (47% vs. 42%, p=0.79). The recurrence of AF was lower in patients who underwent CF-guided ablation with a normal LA dimension (36 %, p=0.54). Procedure duration was longer in patients with severely enlarged LA. LA dimension was not significantly different between patients with and without AF recurrence (49.8 ± 7.9 mm vs. 45.9 ± 7.5 mm, p=0.15). LAD and was significantly correlated with the time to recurrence of AF (r:-0.60, p=0.02). Conclusion Our preliminary findings have demonstrated that CF guided ablation does not improve the success rate in longstanding persistent AF patients with severe LA enlargement.
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Affiliation(s)
- Enes E Gul
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Usama Boles
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Sohaib Haseeb
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Wilma Hopman
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Kevin A Michael
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Chris Simpson
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Hoshiar Abdollah
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Adrian Baranchuk
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Damian Redfearn
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Benedict Glover
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
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