Catheter ablation of persistent atrial fibrillation in a patient with cor triatriatum sinister demonstrating a total common trunk of the pulmonary vein

2014 ◽  
Vol 31 (2) ◽  
pp. 261-264 ◽  
Author(s):  
Michifumi Tokuda ◽  
Teiichi Yamane ◽  
Kenichi Tokutake ◽  
Kenichi Yokoyama ◽  
Mika Hioki ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Persistent Atrial Fibrillation ◽  
Cor Triatriatum ◽  
Common Trunk ◽  
Cor Triatriatum Sinister

Catheter Ablation of Atrial Fibrillation in Patients with Cor Triatriatum Sinister; Case Series and Review of Literature

2021 ◽  
Author(s):  
Ahmadreza Karimianpour ◽  
Amanda W. Cai ◽  
Frank A. Cuoco ◽  
J. Lacy Sturdivant ◽  
Sheldon E. Litwin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Case Series ◽  
Cor Triatriatum ◽  
Review Of Literature ◽  
Cor Triatriatum Sinister

Pulmonary vein isolation alone vs. more extensive ablation with defragmentation and linear ablation of persistent atrial fibrillation: the EARNEST-PVI trial

EP Europace ◽  
2020 ◽  
Author(s):  
Koichi Inoue ◽  
Shungo Hikoso ◽  
Masaharu Masuda ◽  
Yoshio Furukawa ◽  
Akio Hirata ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Primary Endpoint ◽  
Persistent Atrial Fibrillation ◽  
Hazard Ratio ◽  
Complication Rates ◽  
Inferior Margin ◽  
Linear Ablation

Abstract Aims Previous studies could not demonstrate any benefit of more intensive ablation in addition to pulmonary vein isolation (PVI) including complex fractionated atrial electrogram (CFAE) and linear ablation for recurrence in the initial catheter ablation of persistent atrial fibrillation (AF). This study aimed to establish the non-inferiority of PVI alone to PVI plus these additional ablation strategies. Methods and results Patients with persistent AF who underwent an initial catheter ablation (n = 512, long-standing persistent AF; 128 cases) were randomly assigned in a 1:1 ratio to either PVI alone (PVI-alone group) or PVI plus CFAE and/or linear ablation (PVI-plus group). After excluding 15 cases who did not receive procedures, we analysed 249 and 248 patients, respectively. The primary endpoint was recurrence of AF, atrial flutter, and/or atrial tachycardia, and the non-inferior margin was set at a hazard ratio of 1.43. In the PVI-plus group, 85.1% of patients had linear ablation and 15.3% CFAE ablation. After 12 months, freedom from the primary endpoint occurred in 71.3% of patients in the PVI-alone group and in 78.3% in the PVI-plus group [hazard ratio = 1.56 (95% confidence interval: 1.10–2.24), non-inferior P = 0.3062]. The procedure-related complication rates were 2.0% in the PVI-alone group and 3.6% in the PVI-plus group (P = 0.199). Conclusion This randomized trial did not establish the non-inferiority of PVI alone to PVI plus linear ablation or CFAE ablation in patients with persistent AF, but implied that the PVI plus strategy was promising to improve the clinical efficacy (NCT03514693).

scholarly journals 471 Arrhythmia-free survival in early-persistent atrial fibrillation patients undergoing radiofrequency catheter ablation

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Michele Magnocavallo ◽  
Domenico Giovanni Della Rocca ◽  
Carlo Lavalle ◽  
Cristina Chimenti ◽  
Gianni Carola ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Success Rate ◽  
Pulmonary Vein ◽  
Survival Data ◽  
Radiofrequency Catheter Ablation ◽  
Persistent Atrial Fibrillation ◽  
Posterior Wall ◽  
Free Survival ◽  
One Year

Abstract Aims Despite advances in success rate of paroxysmal atrial fibrillation (PAF) ablation, outcomes of radiofrequency catheter ablation (RFCA) in patients with persistent AF are highly variable. Early persistent AF (EPsAF) is defined as AF that is sustained beyond 7 days but is less than 3 months in duration. Arrhythmia-free survival data after RFCA in this specific population are still limited. We sought to report the outcomes of RFCA in the subgroup of patients with EPsAF, compared to those with PAF and with ‘late’ persistent AF (LPsAF) lasting between 3 and 12 months. Methods and results Data from 1143 consecutive AF patients receiving their first RFCA were prospectively collected. Patients with EPsAF (n = 190) were compared with PAF (n = 531) and LPsAF (n = 422) patients. All patients received pulmonary vein antrum isolation + posterior wall and sustained non-pulmonary vein (PV) trigger ablation. Non-sustained non-PV triggers were ablated based on operator discretion. Non-PV triggers were defined as sites of firing leading to sustained (>30 s) or non-sustained arrhythmias (<30 s, including premature atrial contractions ≥10 beats/min) with earliest activation outside the PVs. Mean age of the population was 64 ± 11 years. Female patients were more in PAF group (39%) compared to EPsAF (26%) and LPsAF (28%) (P < 0.001). There was no difference in other clinical characteristics among populations. Non-PV triggers were detected more in EPsAF [127 (66.8%)], and LPsAF [296 (70.1%)] patients compared to PAF [185 (34.8%)] (P < 0.001).One-year arrhythmia-free survival rate after a single procedure was 75.0% (398), 74.2% (141), and 64.5% (272) in PAF, EPsAF, and LPsAF, respectively. Success rate was significantly higher in PAF {[HR: 0.67 (0.53, 0.84), P = 0.001] and EPsAF [HR: 0.67 (0.49, 0.93)], P = 0.015} compared to LPsAF. Conclusions In patients with EPsAF, RFCA may result in significantly better freedom from atrial arrhythmias, compared to LPsAF. In this cohort, ablation might be reasonable as first line approach to improve outcomes and prevent AF progression.

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