Comparison of phase mapping and electrogram-based driver mapping for catheter ablation in atrial fibrillation.
Pacing Clin Electrophysiol
; 42(2): 216-223, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30536679
ABSTRACT
INTRODUCTION:
Adjunctive driver-guided ablation in addition to pulmonary vein isolation has been proposed as a strategy to improve procedural success and outcomes for various populations with atrial fibrillation (AF). First, this study aimed to evaluate the different mapping techniques for driver/rotor identification and second to evaluate the benefits of driver/rotor-guided ablation in patients with paroxysmal and persistent AF (PerAF).METHODS:
We searched the electronic database in PubMed using the keywords "atrial fibrillation," "rotor," "rotational driver," "atrial fibrillation source," and "drivers" for both randomized controlled trials and observational controlled trials. Clinical studies reporting efficacy or safety outcomes of driver-guided ablation for paroxysmal AF or (PerAF) were identified. We performed subgroup analyses comparing different driver mapping methods in patients with PerAF. The odds ratios (ORs) with random effects were analyzed.RESULTS:
Out of 175 published articles, seven met the inclusion criteria, of which two were randomized controlled trials, one was quasiexperimental study, and four observational studies (three case-controlled studies and one cross-sectional study). Overall, adjunctive driver-guided ablation was associated with higher rates of acute AF termination (OR 4.62, 95% confidence interval [CI] 2.12-10.08; P < 0.001), lower recurrence of any atrial arrhythmia (OR 0.44, 95% CI 0.30-0.065; P < 0.001), and comparable complication incidence.CONCLUSIONS:
Adjunctive driver-guided catheter ablation suggested an increased freedom from AF/AT relative to conventional strategies, irrespective of the mapping techniques. Furthermore, phase mapping appears to be superior to electrogram-based driver mapping in PerAF ablation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
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Ablação por Cateter
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Técnicas Eletrofisiológicas Cardíacas
Tipo de estudo:
Clinical_trials
/
Observational_studies
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Prognostic_studies
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Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Taiwan