BACKGROUND: Pulmonary vein (PV) isolation is an established treatment strategy for paroxysmal atrial fibrillation (PAF). However, the recurrence rate of PAF is 8% to 37%, despite repeated procedures, and the catheter ablation strategy for PAF with non-PV foci is unclear. OBJECTIVE: The purpose of this study was to assess the PAF ablation strategy for non-PV foci. METHODS: The study included 304 consecutive patients undergoing PAF ablation (209 males, age 63.0 ± 10.4 years) divided into 3 groups: group 1 (245 patients) with no inducible non-PV foci; group 2 (34 patients) with atrial fibrillation (AF) originating from non-PV foci and all the foci successfully ablated; and group 3 (25 patients) with AF originating from non-PV triggers, but without all foci being ablated or with persistently inducible AF. RESULTS: Mean follow-up period was 26.9 ± 11.8 months, and AF recurrence rates since the last procedure were 9.8%, 8.8%, and 68.0% in groups 1, 2, and 3, respectively. There was no statistically significant difference in recurrence rate between groups 1 and 2 (P = .89); however, there were statistically significant differences between groups 3 and 1 (P <.0001) and groups 3 and 2 (P <.0001). The patients in group 2 had an AF-free outcome to equivalent to those who had PV foci in group 1 (P = .83). CONCLUSION: Success rates can be improved for PAF ablation if non-PV foci are detected and eliminated.
BACKGROUND: Pulmonary vein (PV) isolation is an established treatment strategy for paroxysmal atrial fibrillation (PAF). However, the recurrence rate of PAF is 8% to 37%, despite repeated procedures, and the catheter ablation strategy for PAF with non-PV foci is unclear. OBJECTIVE: The purpose of this study was to assess the PAF ablation strategy for non-PV foci. METHODS: The study included 304 consecutive patients undergoing PAF ablation (209 males, age 63.0 ± 10.4 years) divided into 3 groups: group 1 (245 patients) with no inducible non-PV foci; group 2 (34 patients) with atrial fibrillation (AF) originating from non-PV foci and all the foci successfully ablated; and group 3 (25 patients) with AF originating from non-PV triggers, but without all foci being ablated or with persistently inducible AF. RESULTS: Mean follow-up period was 26.9 ± 11.8 months, and AF recurrence rates since the last procedure were 9.8%, 8.8%, and 68.0% in groups 1, 2, and 3, respectively. There was no statistically significant difference in recurrence rate between groups 1 and 2 (P = .89); however, there were statistically significant differences between groups 3 and 1 (P <.0001) and groups 3 and 2 (P <.0001). The patients in group 2 had an AF-free outcome to equivalent to those who had PV foci in group 1 (P = .83). CONCLUSION: Success rates can be improved for PAF ablation if non-PV foci are detected and eliminated.
Authors: Jim W Cheung; Edward P Cheng; Xian Wu; Ilhwan Yeo; Paul J Christos; Hooman Kamel; Steven M Markowitz; Christopher F Liu; George Thomas; James E Ip; Bruce B Lerman; Luke K Kim Journal: Eur Heart J Date: 2019-09-21 Impact factor: 29.983
Authors: Jesus M Paylos; Aracelis Morales; Luis Azcona; Marisol Paradela; Raquel Yagüe; Fernando Gómez-Guijarro; Lourdes Lacal; R N Clara Ferrero; Octavio Rodríguez Journal: J Atr Fibrillation Date: 2016-04-30