nach oben

Journal of Cardiovascular Translational Research

Erschienen in:

01.04.2013

Catheter Ablation for Long-Standing Persistent Atrial Fibrillation in Patients Who Have Failed Electrical Cardioversion

verfasst von: Fei Lü, Wayne O. Adkisson, Taibo Chen, Baris Akdemir, David G. Benditt

Erschienen in: Journal of Cardiovascular Translational Research | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

Ablation outcomes in 22 consecutive long-standing persistent atrial fibrillation (LPAF) patients with failed direct current cardioversion (DCCV; group 1) were compared with findings in 22 consecutive LPAF patients who had successful DCCV (control 1) and 22 consecutive patients with paroxysmal atrial fibrillation (AF; control 2). All patients underwent a stepwise progressive ablation protocol (pulmonary vein isolation, ablation of complex fractionated atrial electrogram, and repeat ablation of any induced atrial tachycardias). Over 18-month follow-up, 59 % of group 1 patients remained in sinus rhythm without recurrent AF, compared to 64 % and 77 % in controls 1 and 2, respectively. The procedure time was longer in LPAF with a higher procedure complication risk in these 44 LPAF patients (5 % vs. 0 %) than in patients with paroxysmal AF. Our data suggest that catheter ablation provides a practical treatment option with moderate efficacy for restoring sinus rhythm in LPAF patients after failed DCCV.

Wijffels, M. C., Kirchhof, C. J., Dorland, R., & Allessie, M. A. (1995). Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation, 92, 1954–1968.PubMedCrossRef

Wann, L. S., Curtis, A. B., January, C. T., Ellenbogen, K. A., Lowe, J. E., Estes, N. A., 3rd, et al. (2011). ACCF/AHA/HRS. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 57, 223–242.PubMedCrossRef

Calkins, H., Kuck, K. H., Cappato, R., Brugada, J., Camm, A. J., Chen, S. A., et al. (2012). 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design: a report of the Heart Rhythm Society (HRS) task force on catheter and surgical ablation of atrial fibrillation. Heart Rhythm, 9, 632–696.PubMedCrossRef

Nademanee, K., McKenzie, J., Kosar, E., Schwab, M., Sunsaneewitayakul, B., Vasavakul, T., et al. (2004). A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate. Journal of the American College of Cardiology, 43, 2044–2053.PubMedCrossRef

Haïssaguerre, M., Hocini, M., Sanders, P., Sacher, F., Rotter, M., Takahashi, Y., et al. (2005). Catheter ablation of long-lasting persistent atrial fibrillation: clinical outcome and mechanisms of subsequent arrhythmias. Journal of Cardiovascular Electrophysiology, 16, 1138–1147.PubMedCrossRef

Oral, H., Chugh, A., Good, E., Igic, P., Elmouchi, D., Tschopp, D. R., et al. (2005). Randomized comparison of encircling and nonencircling left atrial ablation for chronic atrial fibrillation. Heart Rhythm, 2, 1165–1172.PubMedCrossRef

O'Neill, M. D., Wright, M., Knecht, S., Jaïs, P., Hocini, M., Takahashi, Y., et al. (2009). Long-term follow-up of persistent atrial fibrillation ablation using termination as a procedural endpoint. European Heart Journal, 30, 1105–1112.PubMedCrossRef

Tilz, R. R., Chun, K. R., Schmidt, B., Fuernkranz, A., Wissner, E., Koester, I., et al. (2010). Catheter ablation of long-standing persistent atrial fibrillation: a lesson from circumferential pulmonary vein isolation. Journal of Cardiovascular Electrophysiology, 21, 1085–1093.PubMedCrossRef

Brooks, A. G., Stiles, M. K., Laborderie, J., Lau, D. H., Kuklik, P., Shipp, N. J., et al. (2010). Outcomes of long-standing persistent atrial fibrillation ablation: a systematic review. Heart Rhythm, 7, 835–846.PubMedCrossRef

10.

Rostock, T., Salukhe, T. V., Steven, D., Drewitz, I., Hoffmann, B. A., Bock, K., et al. (2011). Long-term single- and multiple-procedure outcome and predictors of success after catheter ablation for persistent atrial fibrillation. Heart Rhythm, 8, 1391–1397.PubMedCrossRef

11.

Oral, H., Chugh, A., Good, E., Wimmer, A., Dey, S., Gadeela, N., et al. (2007). Radiofrequency catheter ablation of chronic atrial fibrillation guided by complex electrograms. Circulation, 115, 2606–2612.PubMedCrossRef

12.

Oral, H., Chugh, A., Yoshida, K., Sarrazin, J. F., Kuhne, M., Crawford, T., et al. (2009). A randomized assessment of the incremental role of ablation of complex fractionated atrial electrograms after antral pulmonary vein isolation for long-lasting persistent atrial fibrillation. Journal of the American College of Cardiology, 53, 782–789.PubMedCrossRef

13.

Oral, H., Chugh, A., Ozaydin, M., Good, E., Fortino, J., Sankaran, S., et al. (2006). Risk of thromboembolic events after percutaneous left atrial radiofrequency ablation of atrial fibrillation. Circulation, 114, 759–765.PubMedCrossRef

14.

Haissaguerre, M., Jais, P., Shah, D. C., Takahashi, A., Hocini, M., Quiniou, G., et al. (1998). Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. The New England Journal of Medicine, 339, 659–666.PubMedCrossRef

15.

Nagamoto Y., Park JS., Tanubudi D., Ko Y.K., Ban J.E., Kwak J.J., et al. (2012). Clinical significance of induced atrial tachycardia after termination of longstanding persistent atrial fibrillation using a stepwise approach. J Cardiovasc Electrophysiol May 19. [Epub ahead of print].

16.

Oral, H., Pappone, C., Chugh, A., Good, E., Bogun, F., Pelosi, F., Jr., et al. (2006). Circumferential pulmonary-vein ablation for chronic atrial fibrillation. The New England Journal of Medicine, 354, 934–941.PubMedCrossRef

17.

Elayi, C. S., Verma, A., Di Biase, L., Ching, C. K., Patel, D., Barrett, C., et al. (2008). Ablation for longstanding permanent atrial fibrillation: results from a randomized study comparing three different strategies. Heart Rhythm, 5, 1658–1664.PubMedCrossRef

18.

Elayi, C. S., DI Biase, L., Bai, R., Burkhardt, J. D., Mohanty, P., Sanchez, J., et al. (2011). Identifying the relationship between the non-PV Triggers and the critical CFAE sites post-PVAI to curtail the Extent of atrial ablation in longstanding persistent AF. Journal of Cardiovascular Electrophysiology, 22, 1199–1205.PubMedCrossRef

19.

Lau, C. P., Tse, H. F., & Ayers, G. M. (1999). Defibrillation-guided radiofrequency ablation of atrial fibrillation secondary to an atrial focus. Journal of the American College of Cardiology, 33, 1217–1226.PubMedCrossRef

20.

Haïssaguerre, M., Jaïs, P., Shah, D. C., Arentz, T., Kalusche, D., Takahashi, A., et al. (2000). Catheter ablation of chronic atrial fibrillation targeting the reinitiating triggers. Journal of Cardiovascular Electrophysiology, 11, 2–10.PubMedCrossRef

21.

Inoue, K., Kurotobi, T., Kimura, R., Toyoshima, Y., Itoh, N., Masuda, M., et al. (2012). Trigger-based mechanism of the persistence of atrial fibrillation and its impact on the efficacy of catheter ablation. Circulation Arrhythmia and Electrophysiology, 5, 295–301.PubMedCrossRef

22.

Lin, D., Frankel, D. S., Zado, E. S., Gerstenfeld, E., Dixit, S., Callans, D. J., et al. (2012). Pulmonary vein antral isolation and nonpulmonary vein trigger ablation without additional substrate modification for treating longstanding persistent atrial fibrillation. Journal of Cardiovascular Electrophysiology, 23(8), 806–813.PubMedCrossRef

23.

Matsuo, S., Lellouche, N., Wright, M., Bevilacqua, M., Knecht, S., Nault, I., et al. (2009). Clinical predictors of termination and clinical outcome of catheter ablation for persistent atrial fibrillation. Journal of the American College of Cardiology, 54, 788–795.PubMedCrossRef

24.

Weerasooriya, R., Khairy, P., Litalien, J., Macle, L., Hocini, M., Sacher, F., et al. (2011). Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? Journal of the American College of Cardiology, 57, 160–166.PubMedCrossRef

Titel: Catheter Ablation for Long-Standing Persistent Atrial Fibrillation in Patients Who Have Failed Electrical Cardioversion
verfasst von: Fei Lü
Wayne O. Adkisson
Taibo Chen
Baris Akdemir
David G. Benditt
Publikationsdatum: 01.04.2013
Verlag: Springer US
Erschienen in: Journal of Cardiovascular Translational Research / Ausgabe 2/2013
Print ISSN: 1937-5387
Elektronische ISSN: 1937-5395
DOI: https://doi.org/10.1007/s12265-012-9411-6

Neu im Fachgebiet Kardiologie

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Catheter Ablation for Long-Standing Persistent Atrial Fibrillation in Patients Who Have Failed Electrical Cardioversion

Abstract

Neu im Fachgebiet Kardiologie

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

Update Kardiologie

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2013

The Clinical Anatomy and Pathology of the Human Atrioventricular Valves: Implications for Repair or Replacement

Erratum to: Generation of Pig iPS Cells: A Model for Cell Therapy

Methodological Review of Ventricular Anatomy—the Basis for Understanding Congenital Cardiac Malformations

Insights from Cardiac Development Relevant to Congenital Defects and Adult Clinical Anatomy

Novel Imaging of Atrial Septal Defects in Isolated Human Hearts

The Clinical Anatomy and Pathology of the Human Arterial Valves: Implications for Repair or Replacement

Neu im Fachgebiet Kardiologie

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

Update Kardiologie