Document Detail


Clinical characteristics of patients with persistent atrial fibrillation successfully treated by left atrial ablation.
MedLine Citation:
PMID:  20693576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We sought to characterize patients with persistent atrial fibrillation (AF) who were successfully treated by ablation targeting the left atrium (LA).
METHODS AND RESULTS: Ninety-three patients (58±10 years, 79 male) undergoing ablation of persistent AF were studied. During the first procedure, ablation was performed in the LA and coronary sinus, consisting of pulmonary vein isolation, linear ablation, and electrogram-based ablation. During follow-up after the first procedure, 35 patients (38%) remained free from tachyarrhythmias, 27 patients (29%) had atrial tachycardia, and 31 patients (33%) had AF. Duration of persistent AF according to medical history and whether AF was terminated by ablation were associated with the outcome (P=0.005, P=0.004, respectively). In multivariate analysis, the duration of persistent AF was the only predictor of freedom from AF (sinus rhythm or atrial tachycardia) (odds ratio, 0.80 for a 1-year increase; 95% confidence interval, 0.67 to 0.95; P=0.01). Of 31 patients in whom AF recurred during follow-up, electrogram-based ablation was performed in the right atrium in 26 patients. Sixteen of those patients (62%) remained free from AF during follow-up. Overall, 82% of patients were free from any tachyarrhythmias at 2-year follow-up after a median of 2 procedures.
CONCLUSIONS: Patients with shorter duration of persistent AF were more likely to be free from AF by LA ablation. Right atrial ablation may provide incremental efficacy in patients who are refractory to LA ablation.
Authors:
Yoshihide Takahashi; Atsushi Takahashi; Taishi Kuwahara; Tadashi Fujino; Kenji Okubo; Shigeki Kusa; Akira Fujii; Atsuhiko Yagishita; Shinsuke Miyazaki; Toshihiro Nozato; Hiroyuki Hikita; Kenzo Hirao; Mitsuaki Isobe
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-08-07
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  3     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-20     Completed Date:  2010-11-04     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-71     Citation Subset:  IM    
Affiliation:
Yokosuka Kyousai Hospital, Yokosuka, Japan. yoshihide_takahashi@oboe.ocn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / epidemiology,  physiopathology,  surgery*
Catheter Ablation / methods*
Electrocardiography, Ambulatory
Electrophysiologic Techniques, Cardiac / methods
Female
Follow-Up Studies
Heart Atria / innervation*,  physiopathology
Heart Conduction System / physiopathology,  surgery*
Heart Rate / physiology
Humans
Male
Middle Aged
Prevalence
Recurrence
Reoperation / statistics & numerical data
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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