TY - JOUR
T1 - Atrial fibrillation ablation strategies for paroxysmal patients randomized comparison between different techniques
AU - Elayi, Claude S.
AU - Fahmy, Tamer S.
AU - Martin, David O.
AU - Ching, Chi Keong
AU - Barrett, Conor
AU - Bai, Rong
AU - Patel, Dimpi
AU - Khaykin, Yaariv
AU - Hongo, Richard
AU - Hao, Steven
AU - Beheiry, Salwa
AU - Pelargonio, Gemma
AU - Russo, Antonio Dello
AU - Casella, Michela
AU - Santarelli, Pietro
AU - Potenza, Domenico
AU - Fanelli, Raffaele
AU - Massaro, Raimondo
AU - Wang, Paul
AU - Al-Ahmad, Amin
AU - Arruda, Mauricio
AU - Themistoclakis, Sakis
AU - Bonso, Aldo
AU - Rossillo, Antonio
AU - Raviele, Antonio
AU - Schweikert, Robert A.
AU - Burkhardt, David J.
AU - Natale, Andrea
AU - Di Biase, Luigi
PY - 2009/4
Y1 - 2009/4
N2 - Background-Whether different ablation strategies affect paroxysmal atrial fibrillation (AF) long-term freedom from AF/atrial tachyarrhythmia is unclear. We sought to compare the effect of 3 different ablation approaches on the long-term success in patients with paroxysmal AF. Methods and Results-One hundred three consecutive patients with paroxysmal AF scheduled for ablation and presenting in the electrophysiology laboratory in AF were selected for this study. Patients were randomized to pulmonary vein antrum isolation (PVAI; n=35) versus biatrial ablation of the complex fractionated atrial electrograms (CFAEs; n=34) versus PVAI followed by CFAEs (n=34). Patients were given event recorders and followed up at 3, 6, 9, 12, and 15 months postablation. There was no statistical significant difference between the groups in term of sex, age, AF duration, left atrial size, and ejection fraction. At 1 year follow-up, freedom from AF/atrial tachyarrhythmia was documented in 89% of patients in the PVAI group, 91% in the PVAI plus CFAEs group, and 23% in the CFAEs group (P<0.001) after a single procedure and with antiarrhythmic drugs. Conclusion-No difference in terms of success rate was seen between PVAI alone and PVAI associated with defragmentation. CFAEs ablation alone had the smallest impact on AF recurrences at 1-year follow-up. These results suggest that antral isolation is sufficient to treat most patients with paroxysmal AF. (Circ Arrhythmia Electrophysiol. 2009;2:113-119.)
AB - Background-Whether different ablation strategies affect paroxysmal atrial fibrillation (AF) long-term freedom from AF/atrial tachyarrhythmia is unclear. We sought to compare the effect of 3 different ablation approaches on the long-term success in patients with paroxysmal AF. Methods and Results-One hundred three consecutive patients with paroxysmal AF scheduled for ablation and presenting in the electrophysiology laboratory in AF were selected for this study. Patients were randomized to pulmonary vein antrum isolation (PVAI; n=35) versus biatrial ablation of the complex fractionated atrial electrograms (CFAEs; n=34) versus PVAI followed by CFAEs (n=34). Patients were given event recorders and followed up at 3, 6, 9, 12, and 15 months postablation. There was no statistical significant difference between the groups in term of sex, age, AF duration, left atrial size, and ejection fraction. At 1 year follow-up, freedom from AF/atrial tachyarrhythmia was documented in 89% of patients in the PVAI group, 91% in the PVAI plus CFAEs group, and 23% in the CFAEs group (P<0.001) after a single procedure and with antiarrhythmic drugs. Conclusion-No difference in terms of success rate was seen between PVAI alone and PVAI associated with defragmentation. CFAEs ablation alone had the smallest impact on AF recurrences at 1-year follow-up. These results suggest that antral isolation is sufficient to treat most patients with paroxysmal AF. (Circ Arrhythmia Electrophysiol. 2009;2:113-119.)
KW - Catheter ablation
KW - Complex fractionated atrial electrograms or defragmentation
KW - Paroxysmal atrial fibrillation
KW - Pulmonary vein antrum isolation
KW - Radiofrequency
KW - Randomized study
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U2 - 10.1161/CIRCEP.108.798447
DO - 10.1161/CIRCEP.108.798447
M3 - Article
C2 - 19808455
AN - SCOPUS:70349239372
SN - 1941-3149
VL - 2
SP - 113
EP - 119
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
IS - 2
ER -