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Atrial fibrillation ablation by use of electroanatomical mapping: efficacy and recurrence factors.

Kalil C, Bartholomay E, Borges A, Gazzoni G, Lima Ed, Etchepare R, Moraes R, Sussenbach C, Andrade K, Kalil R - Arq. Bras. Cardiol. (2013)

Bottom Line: The inclusion criteria were as follows: minimum age of 18 years; presence of paroxysmal, persistent or long-standing persistent AF; AF recording on an electrocardiogram, exercise testing or Holter monitoring (duration longer than 15 minutes); presence of symptoms associated with AF episodes; AF refractoriness to, at least, two antiarrhythmic drugs, one of which being amiodarone, or impossibility to use antiarrhythmic drugs.The study included 95 patients (age 55 ± 12 years, 84% men, mean CHADS2 = 0.8) who underwent 102 procedures with a median follow-up of 13.4 months.The recurrence-free rate after the procedure was 75.5% after 12 months.

View Article: PubMed Central - PubMed

Affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.

ABSTRACT

Background: Radiofrequency catheter ablation guided by electroanatomical mapping is currently an important therapeutic option for the treatment of atrial fibrillation. The complexity of the procedure, the several techniques used and the diversity of the patients hinder the reproduction of the results and the indication for the procedure.

Objective: To evaluate the efficacy and factors associated with recurrence of atrial fibrillation.

Methods: Prospective cohort study with consecutive patients submitted to atrial fibrillation ablation treatment guided by electroanatomical mapping. The inclusion criteria were as follows: minimum age of 18 years; presence of paroxysmal, persistent or long-standing persistent AF; AF recording on an electrocardiogram, exercise testing or Holter monitoring (duration longer than 15 minutes); presence of symptoms associated with AF episodes; AF refractoriness to, at least, two antiarrhythmic drugs, one of which being amiodarone, or impossibility to use antiarrhythmic drugs.

Results: The study included 95 patients (age 55 ± 12 years, 84% men, mean CHADS2 = 0.8) who underwent 102 procedures with a median follow-up of 13.4 months. The recurrence-free rate after the procedure was 75.5% after 12 months. Atrial fibrillation recurred as follows: 26.9% of patients with paroxysmal and persistent atrial fibrillation; 45.8% of patients with long-standing persistent atrial fibrillation (p = 0.04). Of the analyzed variables, the increased size of the left atrium has proven to be an independent predictor of atrial fibrillation recurrence after the procedure (HR = 2.58; 95% CI: 1.26-4.89). Complications occurred in 4.9% of the procedures.

Conclusion: Atrial fibrillation ablation guided by electroanatomical mapping has shown good efficacy. The increase in left atrium size was associated with atrial fibrillation recurrence.

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Related in: MedlinePlus

Mean duration of the procedure and of radioscopy according to the year theprocedure was performed.
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f01: Mean duration of the procedure and of radioscopy according to the year theprocedure was performed.

Mentions: Figure 1, comparing the total durations of theprocedures and radioscopy between the initial years and more recent ones, shows aprogressive decrease of both total durations (p < 0.001 and p < 0.001,respectively), according to the linear trend test. Between the years 2009 and 2012, theperiod corresponding to the greatest number of procedures, there was an 18-minute/ yearreduction in the total duration of the procedure (p = 0.001) and a 6.6-minute/yearreduction in the total duration of radioscopy (p = 0.005).


Atrial fibrillation ablation by use of electroanatomical mapping: efficacy and recurrence factors.

Kalil C, Bartholomay E, Borges A, Gazzoni G, Lima Ed, Etchepare R, Moraes R, Sussenbach C, Andrade K, Kalil R - Arq. Bras. Cardiol. (2013)

Mean duration of the procedure and of radioscopy according to the year theprocedure was performed.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3987395&req=5

f01: Mean duration of the procedure and of radioscopy according to the year theprocedure was performed.
Mentions: Figure 1, comparing the total durations of theprocedures and radioscopy between the initial years and more recent ones, shows aprogressive decrease of both total durations (p < 0.001 and p < 0.001,respectively), according to the linear trend test. Between the years 2009 and 2012, theperiod corresponding to the greatest number of procedures, there was an 18-minute/ yearreduction in the total duration of the procedure (p = 0.001) and a 6.6-minute/yearreduction in the total duration of radioscopy (p = 0.005).

Bottom Line: The inclusion criteria were as follows: minimum age of 18 years; presence of paroxysmal, persistent or long-standing persistent AF; AF recording on an electrocardiogram, exercise testing or Holter monitoring (duration longer than 15 minutes); presence of symptoms associated with AF episodes; AF refractoriness to, at least, two antiarrhythmic drugs, one of which being amiodarone, or impossibility to use antiarrhythmic drugs.The study included 95 patients (age 55 ± 12 years, 84% men, mean CHADS2 = 0.8) who underwent 102 procedures with a median follow-up of 13.4 months.The recurrence-free rate after the procedure was 75.5% after 12 months.

View Article: PubMed Central - PubMed

Affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas, Porto AlegreRS, Brasil.

ABSTRACT

Background: Radiofrequency catheter ablation guided by electroanatomical mapping is currently an important therapeutic option for the treatment of atrial fibrillation. The complexity of the procedure, the several techniques used and the diversity of the patients hinder the reproduction of the results and the indication for the procedure.

Objective: To evaluate the efficacy and factors associated with recurrence of atrial fibrillation.

Methods: Prospective cohort study with consecutive patients submitted to atrial fibrillation ablation treatment guided by electroanatomical mapping. The inclusion criteria were as follows: minimum age of 18 years; presence of paroxysmal, persistent or long-standing persistent AF; AF recording on an electrocardiogram, exercise testing or Holter monitoring (duration longer than 15 minutes); presence of symptoms associated with AF episodes; AF refractoriness to, at least, two antiarrhythmic drugs, one of which being amiodarone, or impossibility to use antiarrhythmic drugs.

Results: The study included 95 patients (age 55 ± 12 years, 84% men, mean CHADS2 = 0.8) who underwent 102 procedures with a median follow-up of 13.4 months. The recurrence-free rate after the procedure was 75.5% after 12 months. Atrial fibrillation recurred as follows: 26.9% of patients with paroxysmal and persistent atrial fibrillation; 45.8% of patients with long-standing persistent atrial fibrillation (p = 0.04). Of the analyzed variables, the increased size of the left atrium has proven to be an independent predictor of atrial fibrillation recurrence after the procedure (HR = 2.58; 95% CI: 1.26-4.89). Complications occurred in 4.9% of the procedures.

Conclusion: Atrial fibrillation ablation guided by electroanatomical mapping has shown good efficacy. The increase in left atrium size was associated with atrial fibrillation recurrence.

Show MeSH
Related in: MedlinePlus