Impact of Atrial Fibrillation Triggers on Long-Term Outcomes of a Second Catheter Ablation of Nonparoxysmal Atrial Fibrillation

被引:1
|
作者
Shinohara, Masaya [1 ]
Fujino, Tadashi [2 ]
Wada, Ryo [1 ]
Yao, Shintaro [1 ]
Yano, Kensuke [1 ]
Akitsu, Katsuya
Koike, Hideki [1 ]
Kinoshita, Toshio [1 ]
Yuzawa, Hitomi [1 ]
Ikeda, Takanori [2 ]
机构
[1] Toho Univ, Fac Med, Dept Internal Med, Div Cardiovasc Med, 6-11-1 Omorinishi,Ota Ku, Tokyo 1438541, Japan
[2] Toho Univ, Dept Cardiovasc Med, Grad Sch Med, Tokyo, Japan
关键词
Atrial fibrillation; Pulmonary vein isolation; Radiofrequency catheter ablation; Recurrence; Triggers; PULMONARY VEIN ISOLATION; CLINICAL-SIGNIFICANCE; PREMATURE BEATS; PERSISTENT; MYOFIBROBLASTS;
D O I
10.1253/circrep.CR-23-0069
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Catheter ablation (CA) of atrial fibrillation (AF) triggers, including non-pulmonary vein (PV) foci, contributes to improved procedural outcomes. However, the clinical significance of an AF trigger ablation during second CA procedures for nonparoxysmal AF is unknown. Methods and Results: We enrolled 94 patients with nonparoxysmal AF undergoing a second CA. Intracardiac cardioversion during AF using high-dose isoproterenol was performed to determine the presence or absence of AF triggers. PV re-isolations were performed if PV potentials recurred, and if AF triggers appeared from any non-PV sites, additional ablation was added to those sites. We investigated the incidence of atrial arrhythmia recurrence (AAR) >3 months post-CA. Of the 94 enrolled patients, AF triggers were identified in 65 (69.1%), and of those with AF triggers, successful elimination of the triggers was achieved in 47 patients (72.3%). Multivariate analysis revealed that no observed AF triggers were a significant predictor of AAR (hazard ratio [HR] 1.97, 95% confidence interval [CI] 1.21-3.46, P=0.019). In a subanalysis of the patients with AF triggers, multivariate analysis showed that unsuccessful trigger ablation was significantly associated with AAR (HR 5.84, 95% CI 2.79-12.22, P<0.01). Conclusions: Having no observed AF triggers during a second CA session significantly increased the risk of AAR, as did unsuccessful CA of AF triggers.
引用
收藏
页码:37 / 45
页数:9
相关论文
共 50 条
  • [31] Long-term oral anticoagulant after catheter ablation for atrial fibrillation
    Chew, Derek
    Piccini, Jonathan P.
    EUROPACE, 2021, 23 (08): : 1157 - 1165
  • [32] Long-term outcomes (&gt;2 years) of atrial fibrillation ablation using a multi-electrode ablation catheter in patients with paroxysmal atrial fibrillation
    Looi, Khang-Li
    Gajendragadkar, Parag
    Taha, Tamer
    Elsik, Maros
    Scully, Elizabeth
    Heck, Patrick
    Fynn, Simon
    Virdee, Munmohan
    Begley, David
    JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2013, 36 (01) : 61 - 69
  • [33] Long-term single procedure efficacy of catheter ablation of atrial fibrillation
    Cheema, Aamir
    Vasamreddy, Chandrasekhar R.
    Dalal, Darshan
    Marine, Joseph E.
    Dong, Jun
    Henrikson, Charles A.
    Spragg, David
    Cheng, Alan
    Nazarian, Saman
    Sinha, Sunil
    Halperin, Henry
    Berger, Ronald
    Calkins, Hugh
    JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2006, 15 (03) : 145 - 155
  • [34] Usefulness of Long-Term Anticoagulation After Catheter Ablation of Atrial Fibrillation
    Arias, Rafael
    Leef, George
    Daimee, Usama
    Sivasambu, Bhradeev
    Akhtar, Tauseef
    Marine, Joseph E.
    Berger, Ronald
    Calkins, Hugh
    Spragg, David
    AMERICAN JOURNAL OF CARDIOLOGY, 2020, 128 : 12 - 15
  • [35] Long-Term Outcome After Successful Catheter Ablation of Atrial Fibrillation
    Tzou, Wendy S.
    Marchlinski, Francis E.
    Zado, Erica S.
    Lin, David
    Dixit, Sanjay
    Callans, David J.
    Cooper, Joshua M.
    Bala, Rupa
    Garcia, Fermin
    Hutchinson, Mathew D.
    Riley, Michael P.
    Verdino, Ralph
    Gerstenfeld, Edward P.
    CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2010, 3 (03): : 237 - 242
  • [36] Long-term outcome of radiofrequency catheter ablation for persistent atrial fibrillation
    Wang Yubing
    Xu Yanping
    Ling Zhiyu
    Chen Weijie
    Su Li
    Du Huaan
    Xiao Peilin
    Liu Zengzhang
    Yin Yuehui
    MEDICINE, 2018, 97 (29)
  • [37] Long-Term Renal Function after Catheter Ablation of Atrial Fibrillation
    Kovacevic, Vladan
    Marinkovic, Milan M.
    Kocijancic, Aleksandar
    Isailovic, Nikola
    Simic, Jelena
    Mihajlovic, Miroslav
    Vucicevic, Vera
    Potpara, Tatjana S.
    Mujovic, Nebojsa M.
    JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE, 2023, 10 (04)
  • [38] Long-term single procedure efficacy of catheter ablation of atrial fibrillation
    Aamir Cheema
    Chandrasekhar R. Vasamreddy
    Darshan Dalal
    Joseph E. Marine
    Jun Dong
    Charles A. Henrikson
    David Spragg
    Alan Cheng
    Saman Nazarian
    Sunil Sinha
    Henry Halperin
    Ronald Berger
    Hugh Calkins
    Journal of Interventional Cardiac Electrophysiology, 2006, 15 : 145 - 155
  • [39] Impact of type of atrial fibrillation and repeat catheter ablation on long-term freedom from atrial fibrillation: Results from a multicenter study
    Bhargava, Mandeep
    Di Biase, Luigi
    Mohanty, Prasant
    Prasad, Subramanyam
    Martin, David O.
    Williams-Andrews, Michelle
    Wazni, Oussama M.
    Burkhardt, J. David
    Cummings, Jennifer E.
    Khaykin, Yaariv
    Verma, Atul
    Hao, Steven
    Beheiry, Salwa
    Hongo, Richard
    Rossillo, Antonio
    Raviele, Antonio
    Bonso, Aldo
    Themistoclakis, Sakis
    Stewart, Kelly
    Saliba, Walid I.
    Schweikert, Robert A.
    Natale, Andrea
    HEART RHYTHM, 2009, 6 (10) : 1403 - 1412
  • [40] Long-term efficacy and safety of adjunctive ethanol infusion into the vein of Marshall during catheter ablation for nonparoxysmal atrial fibrillation
    Liu, Chih-Min
    Lo, Li-Wei
    Lin, Yenn-Jiang
    Lin, Chin-Yu
    Chang, Shih-Lin
    Chung, Fa-Po
    Chao, Tze-Fan
    Hu, Yu-Feng
    Tuan, Ta-Chuan
    Liao, Jo-Nan
    Chen, Yun-Yu
    Kuo, Ling
    Chang, Ting-Yung
    Hoang, Quang Minh
    Salim, Simon
    Vicera, Jennifer Jeanne B.
    Wu, Cheng-I
    Chuang, Chieh-Mao
    Huang, Ting-Chung
    Chen, Shih-Ann
    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2019, 30 (08) : 1215 - 1228