Prophylactic pulmonary vein isolation during isthmus ablation for atrial flutter: Three-year outcomes of the PREVENT AF I study.
J Cardiovasc Electrophysiol
; 29(6): 872-878, 2018 06.
Article
em En
| MEDLINE
| ID: mdl-29570894
ABSTRACT
INTRODUCTION:
The PREVENT AF I study demonstrated that prophylactic pulmonary vein isolation (PVI) in patients with pure typical atrial flutter (AFL) resulted in substantial reduction of new-onset atrial fibrillation (AF) during 1-year follow-up as assessed by continuous implantable cardiac monitor (ICM). The objective of this study was to assess 3-year outcomes. METHODS ANDRESULTS:
Fifty patients with documented AFL were randomized to either cavotricuspid isthmus (CTI) ablation alone (n = 25) or CTI with concomitant PVI (n = 25). The primary endpoint of the study was the occurrence of any atrial tachyarrhythmia with the monthly burden exceeding 0.5% on the ICM. At the end of 3 years, freedom from any atrial tachyarrhythmia was 48% (95% confidence interval [CI] 32-72%) in the CTI plus PVI group as compared to 20% (95% CI 9-44%) in the CTI-only group (P = 0.01). Freedom from redo procedures was also higher 92% (95% CI 82-100%) versus 68% (95% CI 52-89%), respectively (P = 0.027). The 3-year AF burden favored the combined ablation group 6.2% versus 16.8% (P = 0.03). In the CTI-only group, 12 (48%) patients were hospitalized compared to 4 (16%) in the PVI + CTI group (P = 0.03). Two patients in the CTI-only group developed stroke with no serious adverse events in the PVI + CTI group.CONCLUSION:
Prophylactic PVI in patients with only typical AFL resulted in a significant reduction of new-onset AF and burden during long-term follow-up as assessed by ICM, with consequent reduction in hospitalizations and need to perform repeat ablation for AF.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veias Pulmonares
/
Fibrilação Atrial
/
Flutter Atrial
/
Valva Tricúspide
/
Veia Cava Superior
/
Ablação por Cateter
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article