1
|
Li M, Liu X, Zhang Y, Huang W, Hou B, Huang S, Gao F. Analysis of the success rate of conversion using ibutilide administration in radiofrequency catheter ablation of persistent atrial fibrillation and its effects on postoperative recurrence. BMC Cardiovasc Disord 2024; 24:118. [PMID: 38378465 PMCID: PMC10877843 DOI: 10.1186/s12872-024-03787-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 02/13/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVE To assess the efficacy of ibutilide administration during radiofrequency catheter ablation of persistent atrial fibrillation (AF), to explore the success rate of conversion and related influential factors, and to analyze the effects of ibutilide on postoperative recurrence. METHODS A total of 192 patients with persistent AF who underwent catheter ablation from January 1, 2019, to December 31, 2021. These patients failed in conversion of AF to normal sinus rhythm by intraoperative catheter ablation. Patients were categorized into effective group (115 cases) and ineffective group (77 cases) based on whether sinus rhythm was restored after application of ibutilide. RESULTS The overall success rate of conversion using ibutilide administration was 59.9%. The success rate was associated with weight ((68.12 ± 11.72 vs. 72.83 ± 12.08) kg, P = 0.008), the duration of AF ((34.67 ± 55.68 vs. 66.52 ± 95.21) months, p = 0.008), diameter of left atrium (LAD) ((44.39 ± 5.80 vs. 47.36 ± 6.10) mm,P = 0.002), and N-terminal pro-brain natriuretic peptide (NT-proBNP) level ((854.85 ± 770.84 vs. 662.88 ± 659.18) pg/ml,P = 0.030). The results showed the duration of AF was associated with early recurrence, while early recurrence was not a risk factor for late recurrence. And duration of AF was associated with postoperative maintenance time of normal sinus rhythm, whereas successful conversion into normal sinus rhythm using ibutilide administration had no influence on postoperative maintenance time of normal sinus rhythm. CONCLUSION Ibutilide showed to be effective in catheter ablation of AF, the success rate of conversion was correlated with the duration of AF, LA diameter, and NT-proBNP level. Besides, the duration of AF was found as a risk factor for early postoperative recurrence, while ibutilide administration for successful conversion had no influence on predicting postoperative recurrence and had no influence on postoperative maintenance time of sinus rhythm.
Collapse
Affiliation(s)
- Meijuan Li
- Department of Cardiovascular Medicine, Zhongshan Hospital Xiamen University, Xiamen, 361000, Fujian Province, China
| | - Xiping Liu
- Department of Cardiovascular Medicine, Zhongshan Hospital Xiamen University, Xiamen, 361000, Fujian Province, China
| | - Yan Zhang
- Department of Cardiovascular Medicine, The First Hospital of Fuzhou, Fuzhou, 350000, Fujian Province, China
| | - Weibin Huang
- Department of Cardiovascular Medicine, Zhongshan Hospital Xiamen University, Xiamen, 361000, Fujian Province, China
| | - Bingbo Hou
- Department of Cardiovascular Medicine, Zhongshan Hospital Xiamen University, Xiamen, 361000, Fujian Province, China
| | - Sen Huang
- Department of Cardiovascular Medicine, Zhongshan Hospital Xiamen University, Xiamen, 361000, Fujian Province, China
| | - Feng Gao
- Department of Cardiovascular Medicine, Zhongshan Hospital Xiamen University, Xiamen, 361000, Fujian Province, China.
| |
Collapse
|
2
|
Liu X, He Y, Gui C, Wen W, Jiang Z, Zhong G, Wu M. Comparison of clinical outcomes of Ibutilide-guided cardioversion and direct current synchronized cardioversion after radiofrequency ablation of persistent atrial fibrillation. Front Cardiovasc Med 2023; 10:1141698. [PMID: 38028483 PMCID: PMC10658000 DOI: 10.3389/fcvm.2023.1141698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Backgroup Ibutilide has already been used for cardioversion of persistent atrial fibrillation (PsAF) after radiofrequency catheter ablation (RFCA). The purpose of this study was to determine the effect of Ibutilide-guided cardioversion on clinical outcomes after individualized ablation of PsAF. Methods From October 2020 to September 2021, consecutive patients with PsAF accepted for RFCA were prospectively enrolled. After individualized ablation including pulmonary vein isolation plus left atrial roof line ablation and personalized linear ablation based on left atrial low-voltage zones, patients were divided into the spontaneous conversion (SCV) group, direct current synchronized cardioversion (DCC) group and Ibutilide group according to different cardioversion types during ablation. The rates of freedom from atrial tachyarrhythmia (ATT) among the three groups were evaluated after follow-up. Results In this study, 110 patients were enrolled, including 12 patients with SCV, 50 patients receiving DCC and 48 patients receiving Ibutilide cardioversion after individualized ablation. Among the three groups, the SCV group had shorter AF duration {12 months [interquartile range (IQR) 12-16], P = 0.042} and smaller left atrial diameter (LAD) [35 mm (IQR: 33-42), P = 0.023]. A 12-month freedom from ATT rate was 83.3% in SCV group, 69.4% in DCC group, and 79.2% in Ibutilide group, respectively (Log-rank, P = 0.745). During the follow-up [17 months (IQR: 15-19)], the rate of freedom from ATT of SCV group (83.3%), and Ibutilide group (72.9%) were both higher than that of DCC group (53.1%, P = 0.042). Moreover, Kaplan-Meier analysis showed a significantly higher sinus rhythm (SR) maintenance in Ibutilide group than in DCC group (Log-rank, P = 0.041). After adjusting for risk factors of AF recurrence, the hazard ratio for AF recurrence of the DCC group with reference to the Ibutilide group was 4.10 [95% confidence interval (CI) (1.87-8.98), P < 0.001]. Furthermore, subgroup analysis showed that freedom from ATT rate in effective Ibutilide subgroup was significantly higher than noneffective Ibutilide subgroup (Log-rank, P < 0.001). Conclusion For the treatment of the patients with PsAF, Ibutilide-guided cardioversion after individualized RFCA may be benefit for maintenance of SR compared to conventional DCC, especially for the patients who are effective for administration of Ibutilide.
Collapse
Affiliation(s)
- Xing Liu
- Department of Cardiology, Xiangtan Central Hospital, Xiangtan, China
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan He
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Chun Gui
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Weiming Wen
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhiyuan Jiang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Guoqiang Zhong
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Mingxing Wu
- Department of Cardiology, Xiangtan Central Hospital, Xiangtan, China
| |
Collapse
|
3
|
He SN, Tian Y, Shi L, Wang YJ, Xie BQ, Li XX, Zeng LJ, Yang XC, Liu XP. Identification of circumferential pulmonary vein isolation responders among patients with persistent atrial fibrillation: clinical value of the sequential low-dose ibutilide test. Europace 2021; 22:1197-1205. [PMID: 32514560 DOI: 10.1093/europace/euaa095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/24/2020] [Indexed: 11/12/2022] Open
Abstract
AIMS Circumferential pulmonary vein isolation can be effective as sole treatment for persistent atrial fibrillation. However, identifying those patients who will respond to this therapy remains a challenge. We investigated the clinical value of the sequential low-dose ibutilide test for identifying patients with persistent atrial fibrillation in whom pulmonary vein isolation is effective as sole therapy. METHODS AND RESULTS In a prospective cohort of 180 consecutive patients with persistent atrial fibrillation, intravenous low-dose (0.004 mg/kg) ibutilide was administered 3 days before ablation and after the completion of circumferential pulmonary vein isolation. In patients in whom ibutilide did not terminate atrial fibrillation pre-procedurally, but successfully terminated it intraprocedurally, no further atrial substrate modification was performed. Pre-procedural low-dose ibutilide failed to terminate the arrhythmia in all patients with persistent atrial fibrillation, while pulmonary vein isolation ± low-dose ibutilide terminated persistent atrial fibrillation in 55 (30.6%) of them (PsAF group 1). The remaining 125 (69.4%) patients underwent electrogram-based ablation (PsAF Group 2). The control group comprised 379 consecutive patients with paroxysmal atrial fibrillation who underwent pulmonary vein isolation over the same period. At 24 months follow-up, 39 (70.9%) patients in PsAF Group 1 and 276 (72.8%) patients in the control group were free from atrial tachyarrhythmias (P = NS); the arrhythmia-free rates in both groups were higher than that in PsAF group 2 (58.4%, P = 0.005). CONCLUSION The sequential low-dose ibutilide test is a simple method for identifying patients with persistent atrial fibrillation in whom pulmonary vein isolation alone is an appropriate treatment strategy.
Collapse
Affiliation(s)
- Shu-Nan He
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China.,Heart Center, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Ying Tian
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| | - Liang Shi
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| | - Yan-Jiang Wang
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| | - Bo-Qia Xie
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| | - Xue-Xun Li
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| | - Li-Jun Zeng
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| | - Xin-Chun Yang
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| | - Xing-Peng Liu
- Heart Center, Beijing Chaoyang Hospital, Capital Medical University, No.8 Gong Ti Nan Road, Chaoyang District, Beijing 100020, China
| |
Collapse
|
4
|
Zuo K, Li K, Liu M, Li J, Liu X, Liu X, Zhong J, Yang X. Correlation of left atrial wall thickness and atrial remodeling in atrial fibrillation: Study based on low-dose-ibutilide-facilitated catheter ablation. Medicine (Baltimore) 2019; 98:e15170. [PMID: 30985700 PMCID: PMC6485781 DOI: 10.1097/md.0000000000015170] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Atrial remodeling plays a significant role during the progression of atrial fibrillation (AF). Left atrial wall thickness (LAT) is a subjective and easily acquirable indicator referring to structural remodeling. Therefore, we aimed to investigate the association between LAT and atrial remodeling substrate, and to explore the predictive role of LAT about strong maintenance substrate and poor response to catheter ablation.LAT was measured by cardiac computed tomography in 2 selected locations (roof and floor) in 100 persistent AF patients. Then the low-dose-ibutilide-facilitated catheter ablation was performed and atrial maintenance substrate was categorized as weak, mild, and strong, based on the response to circumferential pulmonary vein isolation or complex fractionated atrial electrograms ablation. During follow-up, the success rate was evaluated. LAT showed a progressive thickening tendency from weak, mild, to strong maintenance substrate (roof: 2.2 mm vs. 2.6 mm vs. 3.9 mm, P < .0001; floor: 1.7 mm vs. 2.0 mm vs. 2.5 mm, P < .0001). During follow-up, the success rate of ablation was decreased with the maintenance substrate strengthening (weak 80%, mild 64.53%, strong 31.43%, P = .009). LA roof thickness >3.10 mm might be the predictor to strong atrial maintenance substrate and poor response to ablation.LAT was associated with the remodeling extent of atrial maintenance substrate and might predict the response to catheter ablation. These findings could help the clinicians to select the appropriate ablative strategy and predict the complexity and prognosis before catheter ablation.
Collapse
Affiliation(s)
- Kun Zuo
- Heart Center & Beijing Key Laboratory of Hypertension
| | - Kuibao Li
- Heart Center & Beijing Key Laboratory of Hypertension
| | - Min Liu
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Heart Center & Beijing Key Laboratory of Hypertension
| | - Xiaoqing Liu
- Heart Center & Beijing Key Laboratory of Hypertension
| | - Xingpeng Liu
- Heart Center & Beijing Key Laboratory of Hypertension
| | | | - Xinchun Yang
- Heart Center & Beijing Key Laboratory of Hypertension
| |
Collapse
|
5
|
van der Heijden CAJ, Vroomen M, Luermans JG, Vos R, Crijns HJGM, Gelsomino S, La Meir M, Pison L, Maesen B. Hybrid versus catheter ablation in patients with persistent and longstanding persistent atrial fibrillation: a systematic review and meta-analysis†. Eur J Cardiothorac Surg 2019; 56:433-443. [DOI: 10.1093/ejcts/ezy475] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/27/2018] [Accepted: 12/06/2018] [Indexed: 02/04/2023] Open
Abstract
Summary
As the mechanisms underlying persistent atrial fibrillation (AF) are still incompletely understood, a ‘gold standard’ strategy for ablation is lacking. The results of catheter ablation, independent of the ablation strategy applied, are disappointing. Hybrid ablation, combining a thoracoscopic epicardial and transvenous endocardial approach, has shown more favourable outcomes. To date, studies comparing both techniques are lacking. Therefore, we conducted a systematic review and meta-analysis of hybrid versus catheter ablation in patients with persistent or longstanding persistent AF. A systematic literature search of studies reporting on catheter and hybrid ablation of persistent or longstanding persistent AF was performed in the PubMed database. All identified articles were screened and checked for eligibility. A meta-analysis was performed on inter-study heterogeneity and pooled correlation between baseline characteristics, primary and secondary outcomes of hybrid and catheter studies. From the 520 articles identified by the search, 34 articles could be included in the analysis. Hybrid ablation resulted in higher freedom of atrial arrhythmias in patients with persistent and longstanding-persistent AF than catheter ablation (70.7% vs 49.9%, P < 0.001). Although hybrid ablation had a slightly higher complication rate than catheter ablation, overall morbidity and mortality were low. In conclusion, hybrid ablation is more effective than catheter ablation in maintaining the sinus rhythm in patients with persistent or longstanding persistent AF. However, data directly comparing both techniques are lacking, and small, heterogenic, single-arm studies in a random-effects model prevent definite conclusions from being drawn. Therefore, larger randomized controlled trials directly comparing both techniques are needed.
Collapse
Affiliation(s)
| | - Mindy Vroomen
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Justin G Luermans
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Rein Vos
- Department of Methodology and Statistics, Maastricht University, Maastricht, Netherlands
| | - Harry J G M Crijns
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Sandro Gelsomino
- Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Mark La Meir
- Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Laurent Pison
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Cardiology, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Bart Maesen
- Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
| |
Collapse
|
6
|
Kawaji T, Shizuta S, Yamagami S, Aizawa T, Komasa A, Yoshizawa T, Kato M, Yokomatsu T, Miki S, Ono K, Kimura T. Clinical Utility of Intravenous Nifekalant Injection during Radiofrequency catheter Ablation for Persistent Atrial Fibrillation. J Atr Fibrillation 2018; 11:1839. [PMID: 30455835 DOI: 10.4022/jafib.1839] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 02/19/2018] [Accepted: 05/14/2018] [Indexed: 11/10/2022]
Abstract
Background Radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF) is still challenging even in RFCA-era for AF. The aim of this study was to assess the clinical utility of nifekalant, a pure potassium channel blocker,during RFCA for persistent AF. Methods and results We retrospectively enrolled 157 consecutive persistentAF patientsundergoing first RFCA procedure withcomplex fractionated atrial electrogram (CFAE)ablation after pulmonary veins isolation and compared outcomes between patientswith (NFK group: N=79) and without (No-NFK group: N=78)additional CFAE ablation using intravenous nifekalant (0.3mg/kg). Primary endpoint was 24-month atrial arrhythmia-free survival post ablation.The prevalence of AF terminationwas significantly higher in NFK group than No-NFK group (64.6% versus 7.7%, P<0.001). Arrhythmia-free survival, however, was not significantly different between 2 groups (61.5% versus 54.1%, P=0.63).There was no significant difference between 2 groups in the prevalence of recurrent atrial tachycardia(25.0% versus 23.5%, P=0.89). Arrhythmia-free survivalin patients with AF termination during procedure was significantly higher thanthose without (73.0% versus 41.0%, P=0.002; adjusted hazard ratio 0.48, 95% confidence interval 0.17-0.84, P=0.02) amongNFK group,but not amongNo-NFK group (66.7% versus 53.2%, P=0.53). Conclusions Intravenous nifekalant injection during additional CFAE ablation did not improve sinus maintenancerate after RFCA procedure for AF, but AF termination by nifekalant injection could be a clinical predictor of better success rates after procedure.
Collapse
Affiliation(s)
| | - Satoshi Shizuta
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Shintaro Yamagami
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Takanori Aizawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Akihiro Komasa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Takashi Yoshizawa
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Masashi Kato
- Department of Cardiology, Mitsubishi Kyoto Hospital
| | | | - Shinji Miki
- Department of Cardiology, Mitsubishi Kyoto Hospital
| | - Koh Ono
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| |
Collapse
|
7
|
Singh SM, d'Avila A, Kim YH, Aryana A, Mangrum JM, Michaud GF, Dukkipati SR, Barrett CD, Heist EK, Parides MK, Thorpe KE, Reddy VY. Termination of persistent atrial fibrillation during pulmonary vein isolation: insight from the MAGIC-AF trial. Europace 2016; 19:1657-1663. [DOI: 10.1093/europace/euw266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/02/2016] [Indexed: 11/15/2022] Open
|
8
|
AKSU TOLGA, GULER TÜMERERDEM, YALIN KIVANC, OTO ALI. Unanswered Questions in Complex Fractionated Atrial Electrogram Ablation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:1269-1278. [DOI: 10.1111/pace.12944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 06/15/2016] [Accepted: 08/18/2016] [Indexed: 12/29/2022]
Affiliation(s)
- TOLGA AKSU
- Department of Cardiology; Kocaeli Derince Education and Research Hospital; Kocaeli Turkey
| | - TÜMER ERDEM GULER
- Department of Cardiology; Kocaeli Derince Education and Research Hospital; Kocaeli Turkey
| | - KIVANC YALIN
- Department of Cardiology; Bayrampasa Kolan Hospital; Istanbul Turkey
| | - ALI OTO
- Department of Cardiology; Ankara Memorial Hospital; Ankara Turkey
| |
Collapse
|
9
|
Singh SM, D'Avila A, Aryana A, Kim YH, Mangrum JM, Michaud GF, Dukkipati SR, Heist EK, Barrett CD, Thorpe KE, Reddy VY. Persistent Atrial Fibrillation Ablation in Females: Insight from the MAGIC-AF Trial. J Cardiovasc Electrophysiol 2016; 27:1259-1263. [PMID: 27461576 DOI: 10.1111/jce.13051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Atrial fibrillation (AF) ablation is less frequently performed in women when compared to men. There are conflicting data on the safety and efficacy of AF ablation in women. The objective of this study was to compare the clinical characteristics and outcomes in a contemporary cohort of men and women undergoing persistent AF ablation procedures. METHODS AND RESULTS A total of 182 men and 53 women undergoing a first-ever persistent AF catheter ablation procedure in The Modified Ablation Guided by Ibutilide Use in Chronic Atrial Fibrillation (MAGIC-AF) trial were evaluated. Clinical and procedural characteristics were compared between each gender. The primary efficacy endpoint was the 1-year single procedure freedom from atrial arrhythmia off anti-arrhythmic drugs. Women undergoing catheter ablation procedures were older than men (P < 0.001). The duration of AF and associated co-morbidities were similar between both genders. Single procedure drug-free atrial arrhythmia recurrence occurred in 53% of the cohort with no difference based on gender (men = 54%, women = 53%; P = 1.0). Procedural (P = 0.04), fluoroscopic (P = 0.02), and ablation times (P = 0.003) were shorter in women compared to men. Periprocedural complications and postablation improvement in quality of life were similar between men and women. CONCLUSION Women undergoing a first-ever persistent AF ablation procedure were older but had similar clinical outcomes and complications when compared with men.
Collapse
Affiliation(s)
- Sheldon M Singh
- Schulich Heart Program, Sunnybrook Health Science Center, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Andre D'Avila
- Helmsley Cardiac Arrhythmia Service, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Instituto de Pesquisa em Arritmia Cardiaca - Hospital Cardiologico, Florianopolis, SC, Brazil
| | - Arash Aryana
- Mercy General Hospital and Dignity Health Heart & Vascular Institute, Sacramento, California, USA
| | - Young-Hoon Kim
- Cardiovascular Division, Korea University Medical Center, Seoul, Korea
| | - J Michael Mangrum
- Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia
| | - Gregory F Michaud
- Cardiovascular Division, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Srinivas R Dukkipati
- Helmsley Cardiac Arrhythmia Service, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - E Kevin Heist
- Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Conor D Barrett
- Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kevin E Thorpe
- Dalla Lana School of Public Health, Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital University of Toronto, Toronto, Canada
| | - Vivek Y Reddy
- Helmsley Cardiac Arrhythmia Service, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
10
|
|
11
|
Shah D. Does targeting ibutilide-resistant CFAE improve outcomes for catheter ablation of persistent AF? Eur Heart J 2016; 37:1622-5. [DOI: 10.1093/eurheartj/ehw109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
|
12
|
Gourraud JB, Andrade JG, Macle L, Mondésert B. Pharmacological Tests in Atrial Fibrillation Ablation. Arrhythm Electrophysiol Rev 2016; 5:170-176. [PMID: 28116081 DOI: 10.15420/aer.2016:27:2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The invasive management of atrial fibrillation (AF) has been considerably changed by the identification of major sites of AF initiation and/or maintenance within the pulmonary vein antra. Percutaneous catheter ablation of these targets has become the standard of care for sustained maintenance of sinus rhythm. Long-term failure of ablation is related to an inability to create a durable transmural lesion or to identify all of the non-pulmonary vein arrhythmia triggers. Pharmacological challenges during catheter ablation have been suggested to improve outcomes in both paroxysmal and persistent AF. Herein we review the mechanism and evidence for the use of pharmacological adjuncts during the catheter ablation of AF.
Collapse
Affiliation(s)
- Jean-Baptiste Gourraud
- Electrophysiology Service, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
| | - Jason G Andrade
- Electrophysiology Service, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
| | - Laurent Macle
- Electrophysiology Service, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
| | - Blandine Mondésert
- Electrophysiology Service, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
| |
Collapse
|