Abstract:
INTRODUCTION:Catheter ablation can terminate persistent atrial fibrillation (AF). However, atrial tachycardia (AT) often arises after termination of AF. METHODS AND RESULTS:Of 215 patients who underwent index stepwise ablation for persistent AF, 141 (66%) patients (64 ± 9 years) in whom AF terminated during the ablation procedure were studied. If AF converted into AT, ablation for AT was subsequently performed. ATs were categorized as focal or macroreentrant AT. We assessed whether type of AT occurring after conversion of AF during the ablation procedure was associated with freedom from atrial tachyarrhythmia (AF or AT) during follow-up. Sinus rhythm was directly restored from AF in 37 patients, while 34, 37, and 33 patients had focal AT alone, a mix of focal and macroreentrant AT, and macroreentrant AT alone after termination of AF, respectively. Arrhythmia-free survival rates at 1 year after the index procedure were 30%, 34%, 61%, and 59% in the patients with focal AT alone, a mix of focal AT and macroreentrant AT, macroreentrant AT alone, and direct restoration of sinus rhythm, respectively (P = 0.004). Type of AT occurring during the index procedure was associated with type of recurrent AT (P = 0.03), but the origin of focal AT occurring during the index ablation differed from that of the recurrent AT in 85% of patients. CONCLUSION:In patients who had AF termination by ablation, occurrence of focal AT during the ablation procedure was associated with worse clinical outcome than occurrence of macroreentrant AT, likely due to ATs arising from other foci during follow-up.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Iwai S,Takahashi Y,Masumura M,Yamashita S,Doi J,Yamamoto T,Sakakibara A,Nomoto H,Yoshida Y,Sugiyama T,Oumi T,Ohno M,Sato Y,Hirao K,Isobe Mdoi
10.1111/jce.13187subject
Has Abstractpub_date
2017-05-01 00:00:00pages
489-497issue
5eissn
1045-3873issn
1540-8167journal_volume
28pub_type
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journal_title:Journal of cardiovascular electrophysiology
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:2018-09-01 00:00:00
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pub_type: 杂志文章,meta分析
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