The Impact of Left Atrial Size on Long-Term Outcome of Catheter Ablation of Chronic Atrial Fibrillation
The Impact of Left Atrial Size on Long-Term Outcome of Catheter Ablation of Chronic Atrial Fibrillation
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DOI：
10.1111/j.1540-8167.2009.01546.x
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发表时间：
2009-11-01
影响因子：
2.7
通讯作者：
Chen, Shih-Ann
中科院分区：
文献类型：
--
作者：
Lo, Li-Wei;Lin, Yenn-Jiang;Chen, Shih-Ann
背景：左心房（LA）大小是房颤（AF）手术终止和长期结局的重要预测因素。我们试图评估长期结果方面的左心房大小和程序termination.Methods：87例连续慢性房颤患者（72名男性，53 +/- 10岁）进行三维标测（NavX）和消融。一种逐步方法，包括环肺静脉（PV）隔离、线性消融和连续复杂碎裂电图（CFE）消融（靶向碎裂间期< 50 ms）。电击复律适用于那些没有任何程序终止。无房颤定义为维持窦性心律，而不使用任何I类或III类抗心律失常药物后的空白period.Results：在87例患者中，所有接受了环肺静脉隔离，93%的线性消融，和59%的连续CFE消融。在21 +/- 12个月的随访期间，与未终止房颤的患者相比，房颤手术终止患者（n = 30）的长期结局更好。此外，Kaplan-Meier分析显示，在左心房直径小于45 mm的患者中（n = 49），实现手术终止时无AF率较高（P = 0.004）。相反，无论是否终止房颤，左心房直径≥ 45 mm（n = 38）的患者的结局相似（P = 0.658）。房颤手术终止与慢性房颤消融术的长期成功相关，特别是在LA直径小于45 mm的患者中。当LA直径>= 45 mm时，终止的有利效果降低。（J.E. Vasc Electrophysiol，第20卷，第100页）。1211-1216，2009年11月）。
Background: The left atrial (LA) size is an important predictor of atrial fibrillation (AF) procedural termination and the long-term outcome. We sought to evaluate the long-term outcome in regard to the LA size and procedural termination.Methods: Eighty-seven consecutive chronic AF patients (72 males, 53 +/- 10 years) underwent 3D mapping (NavX) and ablation. A stepwise approach including circumferential pulmonary vein (PV) isolation, linear ablation, and continuous complex-fractionated electrogram (CFE) ablation (targeting fractionation intervals of < 50 ms). Electrical cardioversion was applied to those without any procedural termination. The freedom from AF was defined as the maintenance of sinus rhythm without the use of any class I or III antiarrhythmic drugs after the blanking period.Results: Among the 87 patients, all received a circumferential PV isolation, 93% a linear ablation, and 59% a continuous CFE ablation. Those with AF procedural termination (n = 30) had a better long-term outcome when compared with those without termination during a follow-up of 21 +/- 12 months. Moreover, a Kaplan-Meier analysis showed that in those with an LA diameter of less than 45 mm (n = 49), the freedom from AF rate was higher when procedural termination was achieved (P = 0.004). On the contrary, the outcome was comparable in those with an LA diameter of >= 45 mm (n = 38), whether AF procedural termination occurred or not (P = 0.658).Conclusions: AF procedural termination was related to the long-term success during chronic AF ablation, especially in those with an LA diameter of less than 45 mm. The favorable effect of termination decreased when the LA diameter was >= 45 mm.(J Cardiovasc Electrophysiol, Vol. 20, pp. 1211-1216, November 2009).