Termination of persistent atrial fibrillation during pulmonary vein isolation

Insight from the MAGIC-AF trial

Sheldon M. Singh, Andre D'Avila, Young Hoon Kim, Arash Aryana, J. Michael Mangrum, Gregory F. Michaud, Srinivas R. Dukkipati, Conor D. Barrett, E. Kevin Heist, Michael K. Parides, Kevin E. Thorpe, Vivek Y. Reddy

Research output: Contribution to journalArticle

Abstract

Aims Controversy on the optimal ablation strategy for persistent atrial fibrillation (AF) exists with limited work evaluating a strategy of pulmonary vein isolation (PVI) alone when AF terminates during PVI. Thirty-five patients had AF termination during PVI in the Modified Ablation Guided by Ibutilide Use in Chronic Atrial Fibrillation (MAGIC-AF; ClinicalTrials.gov number: NCT01014741) study. The objective of the current study is to report the 1-year outcome after PVI alone in this unique patient group. Methods and results The 1-year single procedure freedom from atrial arrhythmia off anti-arrhythmic drugs was reported for the 35 patients in the MAGIC-AF study with persistent AF termination during or upon completion of PVI. Freedom from recurrent atrial arrhythmia was achieved in 60% of patients where AF terminated during PVI. Cavotricuspid isthmus flutter was common when AF terminated to a macro re-entrant flutter during PVI, and responsible for 92% of all flutter circuits with AF termination. Conclusions Persistent AF termination during PVI may identify a subgroup of patients who experience a similar long-term clinical outcome with PVI ablation alone when compared with other more extensive persistent AF ablation strategies. Pulmonary vein isolation alone may be an appropriate tactic in this subgroup of persistent AF patients.

Original languageEnglish (US)
Pages (from-to)1657-1663
Number of pages7
JournalEuropace
Volume19
Issue number10
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

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Pulmonary Veins
Atrial Fibrillation
Cardiac Arrhythmias
Anti-Arrhythmia Agents

Keywords

  • Arrhythmia
  • Atrial fibrillation
  • Catheter ablation
  • Electrophysiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Singh, S. M., D'Avila, A., Kim, Y. H., Aryana, A., Mangrum, J. M., Michaud, G. F., ... Reddy, V. Y. (2017). Termination of persistent atrial fibrillation during pulmonary vein isolation: Insight from the MAGIC-AF trial. Europace, 19(10), 1657-1663. https://doi.org/10.1093/europace/euw266

Termination of persistent atrial fibrillation during pulmonary vein isolation : Insight from the MAGIC-AF trial. / Singh, Sheldon M.; D'Avila, Andre; Kim, Young Hoon; Aryana, Arash; Mangrum, J. Michael; Michaud, Gregory F.; Dukkipati, Srinivas R.; Barrett, Conor D.; Heist, E. Kevin; Parides, Michael K.; Thorpe, Kevin E.; Reddy, Vivek Y.

In: Europace, Vol. 19, No. 10, 01.10.2017, p. 1657-1663.

Research output: Contribution to journalArticle

Singh, SM, D'Avila, A, Kim, YH, Aryana, A, Mangrum, JM, Michaud, GF, Dukkipati, SR, Barrett, CD, Heist, EK, Parides, MK, Thorpe, KE & Reddy, VY 2017, 'Termination of persistent atrial fibrillation during pulmonary vein isolation: Insight from the MAGIC-AF trial', Europace, vol. 19, no. 10, pp. 1657-1663. https://doi.org/10.1093/europace/euw266
Singh, Sheldon M. ; D'Avila, Andre ; Kim, Young Hoon ; Aryana, Arash ; Mangrum, J. Michael ; Michaud, Gregory F. ; Dukkipati, Srinivas R. ; Barrett, Conor D. ; Heist, E. Kevin ; Parides, Michael K. ; Thorpe, Kevin E. ; Reddy, Vivek Y. / Termination of persistent atrial fibrillation during pulmonary vein isolation : Insight from the MAGIC-AF trial. In: Europace. 2017 ; Vol. 19, No. 10. pp. 1657-1663.
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