التفاصيل البيبلوغرافية
| العنوان: |
A Prospective and Randomized Comparison of Limited Versus Extensive Atrial Substrate Modification After Circumferential Pulmonary Vein Isolation in Nonparoxysmal Atrial Fibrillation |
| المؤلفون: |
LIN, YENN‐JIANG, CHANG, SHIH‐LIN, LO, LI‐WEI, HU, YU‐FENG, CHONG, ERIC, CHAO, TZE‐FAN, CHUNG, FA‐PO, LIAO, JONAN, LI, CHENG‐HUNG, TSAO, HSUAN‐MING, KAO, TSAIR, CHEN, YUN‐YU, HUANG, JIN‐LONG, CHEN, SHIH‐ANN |
| المساهمون: |
National Science Council (NSC) |
| المصدر: |
Journal of Cardiovascular Electrophysiology ; volume 25, issue 8, page 803-812 ; ISSN 1045-3873 1540-8167 |
| بيانات النشر: |
Wiley |
| سنة النشر: |
2014 |
| المجموعة: |
Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: |
Substrate Modification in Persistent Atrial Fibrillation Introduction The optimal substrate ablation approach in patients with persistent atrial fibrillation (Per AF) remains unclear. This was a prospective randomized study comparing the efficacy of limited (continuous complex fractionated atrial electrogram, CFAE: <60 milliseconds) versus extensive (continuous CFAE plus variable CFAE: <120 milliseconds) atrial substrate modification in Per AF patients. Methods and Results We enrolled 120 Per AF patients in the study, and 30 patients with AF termination after pulmonary vein isolation (PVI) were excluded. In the remaining 90 patients, 45 were treated with limited approach (Group 1) and 45 with an extensive approach (Group 2). The end point of the study was the incidence of an atrial arrhythmia recurrence postblanking period. The patients were followed up for 15 months with 3‐month clinical reviews, electrograms (ECGs), Holter recordings, and echocardiographic monitoring. Procedural AF termination and the single procedural efficacy were statistically comparable between the 2 groups (48.9% vs. 63.4% in Groups 1 and 2, respectively, P = 0.289). During the follow‐up, patients who received limited ablation had a lower incidence of recurrent AFL (P = 0.04), and better reverse remodeling of the left atrium (LA, P = 0.04). After 2 procedures, the freedom from any atrial arrhythmia was better in Group 2 (62.2% vs. 87.8%, P = 0.009). Those with longstanding AF and a larger baseline LA size responded better to the extensive ablation. Conclusions In the Per AF patients who failed to achieve AF termination after PVI alone, a specific atrial substrate modification approach targeting only continuous CFAEs could be considered as an initial ablation strategy. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1111/jce.12407 |
| الإتاحة: |
https://doi.org/10.1111/jce.12407Test |
| حقوق: |
http://onlinelibrary.wiley.com/termsAndConditions#vorTest |
| رقم الانضمام: |
edsbas.4D6D8AA4 |
| قاعدة البيانات: |
BASE |
