Circumferential pulmonary vein antrum ablation for the treatment of paroxysmal atrial fibrillation: A randomized controlled trial.
Pacing Clin Electrophysiol
; 43(3): 280-288, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-31849079
ABSTRACT
BACKGROUND:
It remains unclear whether the curative result of paroxysmal atrial fibrillation (PAF) is a result of pulmonary vein (PV) isolation, PV antrum modification (PVAM), or both. We hypothesized that sufficient antrum modification (PVAM) is as important as PV isolation (PVI) for atrial fibrillation (AF) control and that PVAM can be evaluated by quantified lesion deployment using a force-sensing catheter. METHODS ANDRESULTS:
Patients of symptomatic PAF were randomly assigned 21 into a PVAM group or a circumferential PV isolation (CPVI) group. In the PVAM group, circumferential quantitative ablation evaluated by automatical VisiTag module was performed. In the CPVI group, conventional circumferential ablation was performed to achieve the end point of all-PV isolation. In total, 180 patients with PAF were enrolled and randomly assigned to either the PVAM group (n = 120) or the CPVI group (n = 60). A total of 179 patients successfully underwent ablation. In the PVAM group, 68 patients achieved all PVI (PVAM-PVI), while 51 did not (PVAM-non-PVI). At 18 months, there was no significant difference in the maintenance of sinus rhythm between the PVAM and CPVI groups (84.9 vs 79.7%, P = .382). The PVAM-PVI subgroup demonstrated a higher arrhythmia-free survival compared with the PVAM-non-PVI subgroup (92.6 vs 74.5%, P = .006) and the CPVI group (92.6 vs 79.7%, P = .036).CONCLUSIONS:
The trial shows that sufficient force-sensing guided PVAM can result in satisfying outcomes in PAF patients. Notably, sufficient PVAM with all-PV isolated will further increase the success rate.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Veias Pulmonares
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Fibrilação Atrial
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Ablação por Cateter
Tipo de estudo:
Clinical_trials
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2020
Tipo de documento:
Article