Document Detail


Catheter ablation of atrial fibrillation in patients with valvular heart disease: long-term follow-up results.
MedLine Citation:
PMID:  20550616     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study is to evaluate the efficacy of atrial fibrillation (AF) ablation in patients with moderate valvular heart disease (VHD).
METHODS: In total, 534 consecutive patients who underwent AF ablation were enrolled. Patients with a history of valve surgery or other structural heart disease were excluded. Patients with clinically moderate VHD (group-1, n = 45) were compared with those without VHD (control group-2, n = 436). Ipsilateral pulmonary vein antrum isolation (PVAI) was performed with a double Lasso technique in all the patients. Left atrial (LA) linear ablation was undertaken in persistent AF patients, if AF was inducible after PVAI.
RESULTS: Patients in group-1 were significantly older and had a larger LA. PVAI was successfully achieved in all the patients. Patients in group-1 received LA linear ablation more frequently during the index procedure. After a median of 26 months from the index procedure, the freedom from AF was significantly lower in group-1 than group-2 off antiarrhythmic drugs (AADs) (47% vs 69%, P = 0.002). Although there were more number of total procedures in group-1 than group-2, the freedom from AF was lower at median 24 months after the last procedure (78% vs 87%, P = 0.038). There was no significant difference in the freedom from AF on AADs (91% vs 95%, P = 0.356) or complication rate between the 2 groups. Atrial tachycardia following the index procedure was observed more frequently in group-1 (P = 0.001).
CONCLUSION: The patients with VHD undergoing AF ablation are less likely to remain in sinus rhythm at long term without AADs than those without VHD.
Authors:
Shinsuke Miyazaki; Taishi Kuwahara; Atsushi Kobori; Yoshihide Takahashi; Asumi Takei; Akira Sato; Mitsuaki Isobe; Atsushi Takahashi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  21     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1193-8     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Affiliation:
Cardiovascular Center, Yokosuka Kyosai Hospital, Yonegahamadori, Yokosuka-shi, Kanagawa-ken, Japan. mshinsuke@k3.dion.ne.jp
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Comment In:
J Cardiovasc Electrophysiol. 2010 Nov;21(11):1199-201   [PMID:  20662979 ]

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