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https://hdl.handle.net/2440/34683
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Type: | Journal article |
Title: | Changes in atrial fibrillation cycle length and inducibility during catheter ablation and their relation to outcome |
Author: | Haissaguerre, M. Sanders, P. Hocini, M. Hsu, L. Shah, D. Scavee, C. Takahashi, Y. Rotter, M. Pasquie, J. Garrigue, S. Clementy, J. Jais, P. |
Citation: | Circulation, 2004; 109(24):3007-3013 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2004 |
ISSN: | 0009-7322 1524-4539 |
Statement of Responsibility: | Michel Haïssaguerre, Prashanthan Sanders, Mélèze Hocini, Li-Fern Hsu, Dipen C. Shah, Christophe Scavée, Yoshihide Takahashi, Martin Rotter, Jean-Luc Pasquié, Stéphane Garrigue, Jacques Clémenty, and Pierre Jaïs |
Abstract: | <h4>Background</h4>The modification of atrial fibrillation cycle length (AFCL) during catheter ablation in humans has not been evaluated.<h4>Methods and results</h4>Seventy patients undergoing ablation of prolonged episodes of AF were randomized to pulmonary vein (PV) isolation or additional ablation of the mitral isthmus. Mean AFCL was determined at a distance from the ablated area (coronary sinus) at the following intervals: before ablation, after 2- and 4-PV isolations, and after linear ablation. Inducibility of sustained AF (> or =10 minutes) was determined before and after ablation. Spontaneous sustained AF (715+/-845 minutes) was present in 30 patients and induced in 26 (AFCL, 186+/-19 ms). PV isolation terminated AF in 75%, with the number of PVs requiring isolation before termination increasing with AF duration (P=0.018). PV isolation resulted in progressive or abrupt AFCL prolongation to various extents, depending on the PV: to 214+/-24 ms (P<0.0001) when AF terminated and to 194+/-19 ms (P=0.002) when AF persisted. The increase in AFCL (30+/-17 versus 14+/-11 ms; P=0.005) and the decrease in fragmentation (30.0+/-26.8% to 10.3+/-14.5%; P<0.0001) were significantly greater in patients with AF termination. Linear ablation prolonged AFCL, with a greater prolongation in patients with AF termination (44+/-13 versus 22+/-23 ms; P=0.08). Sustained AF was noninducible in 57% after PV isolation and in 77% after linear ablation. At 7+/-3 months, 74% with PV isolation and 83% with linear ablation were arrhythmia free without antiarrhythmics, which was significantly associated with noninducibility (P=0.03) with a recurrence rate of 38% and 13% in patients with and without inducibility, respectively.<h4>Conclusions</h4>AF ablation results in a decline in AF frequency, with a magnitude correlating with termination of AF and prevention of inducibility that is predictive of subsequent clinical outcome. |
Keywords: | arrhythmia cardioversion drugs electrophysiology surgery |
Description: | © 2004 American Heart Association, Inc. |
DOI: | 10.1161/01.CIR.0000130645.95357.97 |
Published version: | http://dx.doi.org/10.1161/01.cir.0000130645.95357.97 |
Appears in Collections: | Aurora harvest Medicine publications |
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