Arrhythmia Type After Persistent Atrial Fibrillation Ablation Predicts Success of the Repeat Procedure
Arrhythmia Type After Persistent Atrial Fibrillation Ablation Predicts Success of the Repeat Procedure
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DOI：
10.1161/circep.111.963256
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发表时间：
2011-10-01
影响因子：
8.4
通讯作者：
Deisenhofer, Isabel
中科院分区：
文献类型：
--
作者：
Ammar, Sonia;Hessling, Gabriele;Deisenhofer, Isabel
背景：本研究的目的是调查持续性房颤消融后心律失常复发的类型是否对重复消融术后维持窦性心律有影响。方法和结果-连续78例持续性房颤患者(男性82%，平均年龄61+/-10岁，平均左房内径47+/-4 mm)接受>；=1次消融。最初的消融程序包括肺静脉隔离和额外的底物修改(消融复杂的分段性心房电信号[n=63]或线性病变[n=15])。有持续性房性心动过速(AT)(组1，n=36)、持续性房颤(组2，n=37)和阵发性房颤(组3，n=5)的患者接受了消融。主要终点是在消融手术后6个月和9个月不再使用任何抗心律失常药物。在6个月时，第1组、第2组和第3组达到主要终点的患者比例分别为59%、28%和100%，在第9个月时，第1、2和第3组分别达到51%、23%和100%(P=0.002)。结论：在持续性房颤消融后再次手术的患者中，房颤的发生与复发的持续性房颤相比，预后显著改善。这些结果表明，AT可能被认为是向窦性心律迈进的一步。(CIRC节律电生理。2011；4：609-614。)
Background-The aim of the study was to investigate whether the type of arrhythmia recurrence after ablation of persistent atrial fibrillation (AF) has an impact on the maintenance of sinus rhythm after the repeat ablation procedure.Methods and Results-Included were 78 consecutive patients (82% men; mean age, 61 +/- 10 years; mean left atrial diameter, 47 +/- 4 mm) with persistent AF who underwent >= 1 repeat ablation. The initial ablation procedure had consisted of pulmonary vein isolation with additional substrate modification (ablation of complex fractionated atrial electrograms [n=63] or linear lesions [n=15]). Patients presented for reablation either with persistent atrial tachycardia (AT) (group 1, n=36), persistent AF (group 2, n=37), or paroxysmal AF (group 3, n=5). The primary end point was freedom from any arrhythmia off antiarrhythmic drugs 6 and 9 months after the reablation procedure. Estimated proportions of patients reaching the primary end point were 59% for group 1, 28% for group 2, and 100% for group 3 at 6 months and 51%, 23%, and 100%, for groups 1, 2, and 3, respectively, at 9 months (P=0.002).Conclusions-In patients presenting for a repeat procedure after ablation of persistent AF, the occurrence of AT is associated with a significantly better outcome compared with recurrent persistent AF. These results suggest that AT might be considered as a step toward sinus rhythm. (Circ Arrhythm Electrophysiol. 2011;4:609-614.)