Optimal endpoint for catheter ablation of longstanding persistent atrial fibrillation: A randomized clinical trial

Yuan Long Wang, Xu Liu, Yu Zhang, Wei Feng Jiang, Li Zhou, Mu Qin, Dao Liang Zhang, Xiao Dong Zhang, Shao Hui Wu, Kai Xu

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: In longstanding persistent atrial fibrillation (LPeAF), the ideal endpoint of ablation remains to be determined. This study was to explore the value of pursuing AF termination or no with the same strategy during ablation on the long-term outcomes in patients with LPeAF. Methods: Utilized “CCL” strategy is a fixed ablation approach consisting of circumferential pulmonary vein antrum isolation, ablation of complex fractionated atrial electrogram, and linear ablation between two anatomical structures (the mitral isthmus, left atrial roof). Note that 400 patients were randomized to group A (technical endpoint) and group B (pursuing AF termination). Results: A group with technical endpoint had lower rate of acute AF termination (AF→sinus rhythm, 3.5% vs 18.1%; AF→atrial tachycardia, 23.7% vs 44.7%; P < 0.01) and shorter duration of ablation (164.9 ± 20.8 vs 223.4 ± 24.9, P < 0.01), radiofrequency delivery time (69.8 ± 18.1 vs 102.2 ± 26.3, P < 0.01), and x-ray exposure time (18.2 ± 8.8 vs 27.9 ± 12.4, P < 0.01) than those in B group (pursuing AF termination). During follow-up, freedom from atrial arrhythmias did not differ between the two groups after a single ablation procedure (46.5% vs 54.3%, P=0.12) and the final ablation procedure (60.1% vs 65.8%, P = 0.24). Conclusion: In patients of LPeAF, pursuing AF termination during ablation was associated with similar long-term clinical outcome compared to that with technical endpoint. Ablation to termination is not the best strategy during ablation.

Original languageEnglish (US)
Pages (from-to)172-178
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume41
Issue number2
DOIs
StatePublished - Feb 2018
Externally publishedYes

Keywords

  • catheter ablation
  • circumferential pulmonary vein antrum isolation
  • complex fractionated atrial electrogram
  • linear ablation
  • longstanding persistent atrial fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Optimal endpoint for catheter ablation of longstanding persistent atrial fibrillation: A randomized clinical trial'. Together they form a unique fingerprint.

Cite this