TY - JOUR
T1 - Radiofrequency ablation of atrial fibrillation in patients with mitral or aortic mechanical prosthetic valves
T2 - A feasibility, safety, and efficacy study
AU - Lakkireddy, Dhanunjaya
AU - Nagarajan, Darbhamulla
AU - Di Biase, Luigi
AU - Vanga, Subba Reddy
AU - Mahapatra, Srijoy
AU - Jared Bunch, T.
AU - Day, John D.
AU - Burkhardt, David J.
AU - Umbarger, Linda
AU - Dendi, Raghuveer
AU - Pimentel, Rhea
AU - Berenbom, Loren
AU - Emert, Martin
AU - Gerken, Anna
AU - Bommana, Sudharani
AU - Ray, Wallace
AU - Atkins, Donita
AU - Murray, Caroline
AU - Dawn, Buddhadeb
AU - Natale, Andrea
PY - 2011/7
Y1 - 2011/7
N2 - Background: Patients with prosthetic valves have a high prevalence of atrial fibrillation (AF). We report a multicenter experience of performing pulmonary vein antral isolation (PVAI) in this challenging, high-risk cohort of patients. Objective: The purpose of this study was to assess the feasibility, safety, and efficacy of radiofrequency (RF) ablation for sinus rhythm restoration in AF patients with mitral or aortic mechanical prosthetic valves. Methods: A total of 50 patients with prosthetic valves (group I) who underwent RF ablation for AF between January 1, 2007, and April 30, 2009, were identified prospectively at four tertiary care centers. A matched group of 50 patients (group II) acted as controls. Results: Total procedural time (199.4 ± 49 minutes vs 166.6 ± 27.5 minutes, P <.001) and fluoroscopy time (60 ± 17 minutes vs 53.8 ± 6.8 minutes, P <.01) were prolonged, with a higher incidence of atrial flutter at 3 months in group I (18% vs 6%, P = .1) compared to group II. At 12 months, 80% of patients in the valve group were in sinus rhythm after an average of 1.3 procedures, and 82% of controls were in sinus rhythm after an average 1.2 procedures (P = .9). There was a trend toward a higher nonfatal complication rate in the valve group than in the control group (8% vs 4%, P = .1). Conclusion: In patients with prosthetic valves, RF ablation for AF is feasible, safe, and efficacious, with a trend toward a higher nonfatal complication rate and an increased rate of postablation atrial flutter.
AB - Background: Patients with prosthetic valves have a high prevalence of atrial fibrillation (AF). We report a multicenter experience of performing pulmonary vein antral isolation (PVAI) in this challenging, high-risk cohort of patients. Objective: The purpose of this study was to assess the feasibility, safety, and efficacy of radiofrequency (RF) ablation for sinus rhythm restoration in AF patients with mitral or aortic mechanical prosthetic valves. Methods: A total of 50 patients with prosthetic valves (group I) who underwent RF ablation for AF between January 1, 2007, and April 30, 2009, were identified prospectively at four tertiary care centers. A matched group of 50 patients (group II) acted as controls. Results: Total procedural time (199.4 ± 49 minutes vs 166.6 ± 27.5 minutes, P <.001) and fluoroscopy time (60 ± 17 minutes vs 53.8 ± 6.8 minutes, P <.01) were prolonged, with a higher incidence of atrial flutter at 3 months in group I (18% vs 6%, P = .1) compared to group II. At 12 months, 80% of patients in the valve group were in sinus rhythm after an average of 1.3 procedures, and 82% of controls were in sinus rhythm after an average 1.2 procedures (P = .9). There was a trend toward a higher nonfatal complication rate in the valve group than in the control group (8% vs 4%, P = .1). Conclusion: In patients with prosthetic valves, RF ablation for AF is feasible, safe, and efficacious, with a trend toward a higher nonfatal complication rate and an increased rate of postablation atrial flutter.
KW - Atrial fibrillation
KW - Prosthetic valve
KW - Radiofrequency ablation
UR - http://www.scopus.com/inward/record.url?scp=79960044053&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960044053&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2011.02.012
DO - 10.1016/j.hrthm.2011.02.012
M3 - Article
C2 - 21316485
AN - SCOPUS:79960044053
SN - 1547-5271
VL - 8
SP - 975
EP - 980
JO - Heart Rhythm
JF - Heart Rhythm
IS - 7
ER -