Abstract 15258: The Association of Genetic Polymorphism of rs2106261 in ZFHX3 and ‘Super-responder’ to Catheter Ablation Among the Patients With Long-standing Persistent Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Jin kyu Park ◽  
Junbeom Park ◽  
Jae-Sun Uhm ◽  
Boyoung Joung ◽  
Moon-Hyong Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Genetic Polymorphism ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Persistent Atrial Fibrillation ◽  
P Wave ◽  
Volume Index ◽  
Genome Wide Association Studies ◽  
Clinical Recurrence

Introduction: The radiofrequency catheter ablation (RFCA) is challenging in patients with long-standing persistent atrial fibrillation (PeAF) and its clinical outcome is highly variable. Genome-wide association studies (GWAS) have identified that the rs2106261 polymorphism in ZFHX3 is associated with non-valuvluar AF. Hypothesis: We tested the association between the “super-responder” to the radiofrequency catheter ablation (RFCA) and the rs2106261 polymorphism among the patients with long-standing persistent AF. Methods: We included consecutive 207 patients with long-standing PeAF (79.2% male, age 58.0±9.7 years and follow-up interval 21 (16-34) months) who underwent RFCA for symptomatic long-standing PeAF. The super-responders were defined as the patients without early or clinical recurrence of AF at least for 12 months of post-procedural follow-up period without taking anti-arrhythmic drug. We looked for the characteristics of super-responders in clinical profiles, ECG in sinus rhythm, 3D-left atrial (LA) CT, or genotypes of the rs2106262. Results: 1. Fifty two patients (25.1%) were categorized as super-responders. Super-responders were younger (55.5±9.6 vs. 58.9±9.6 years old, p=0.028) and had shorter AF duration (44.9 [25.4-73.1] vs. 65.1 [34.1-113.6] month, p=0.010), shorter QTc (435.1±27.8 vs. 447.3±29.1 msec, p=0.007), lower negative P wave amplitude in lead V1 (0.07±0.03 vs. 0.08±0.04, p=0.034), and smaller LA volume index (CT) (75.2±21.0 vs. 88.2±24.1, p=0.001) than recurred patient group. 2. In additive model, the minor allele frequency of the rs2106261 was higher in super-responders (52.2%) than in recurred group (40.9%, p=0.058). 3. In multivariate analyses, LA volume index (adjusted OR=0.973, 95% CI 0.955-0.992, p=0.006) and genetic polymorphism of the rs2106261 (adjusted OR=1.808, 95% CI 1.034-3.163, p=0.038) were independently associated with super-responder to RFCA among the patients with long-standing persistent AF. Conclusion: Although the recurrence rate after catheter ablation for long-standing persistent AF is still high, pre-procedural LA volume index or the rs2106261 polymorphism may be helpful for the selection of good candidate for RFCA.

scholarly journals Evaluation of proarrythmogenic effects after different techniques of radiofrequency catheter ablation of atrial fibrillation

2015 ◽  
Vol 17 (1) ◽  
pp. 33 ◽  
Author(s):  
S. N. Artemenko ◽  
A. B. Romanov ◽  
V. V. Shabanov ◽  
I. G. Stenin ◽  
D. A. Yelesin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrium ◽  
Radiofrequency Catheter Ablation ◽  
Persistent Atrial Fibrillation ◽  
Linear Lesions ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

To assess proarrythmogenic effects after different techniques of radiofrequency catheter ablation, 427 patients with paroxysmal, persistent, and long-standing persistent atrial fibrillation (AF) were examined. The patients were randomized into four groups: antral pulmonary vein isolation (PVI) (Group I), PVI plus roof line and mitral isthmus ablation (Group II), anatomic ablation of ganglionated plexuses (GP) of the left atrium (Group III) and GP plus PVI (Group IV). At the end of follow up (34,43,2 months) the largest number of proarrythmogenic effects was observed in Group II, 24,8% (26 patients). In the remaining groups the percentage of proarrythmogenic effects did not exceed 11%, neither was there any significant difference among Groups I, III and IV. Thus, the creation of additional linear lesions in the left atrium is a predictor of proarrythmogenic effects during follow up.

scholarly journals Electrical posterior box isolation in persistent atrial fibrillation changed to paroxysmal atrial fibrillation: a multi-center, prospective, randomized study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H.N Pak ◽  
J.B Park ◽  
H.T Yu ◽  
T.H Kim ◽  
J.S Uhm ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Recurrence Rate ◽  
Antiarrhythmic Drug ◽  
Persistent Atrial Fibrillation ◽  
Complication Rates ◽  
Clinical Recurrence ◽  
End Point ◽  
Significant Difference

Abstract Background Persistent atrial fibrillation (PeAF) can change to paroxysmal AF (PAF) after antiarrhythmic drug medication and cardioversion. Purpose We investigated whether electrical posterior box isolation (POBI) may improve rhythm outcome of catheter ablation in those patient group. Methods We prospectively randomized 114 patients with PeAF to PAF (male 75%, 59.8±9.9 years old) to circumferential pulmonary vein isolation (CPVI) alone group (n=57) and additional POBI group (n=57). The primary end-point was AF recurrence after a single procedure, and the secondary end-point was a recurrence pattern, cardioversion rate, and the response to antiarrhythmic drugs (AADs). Results After a mean follow-up of 22.5±9.4 months, the clinical recurrence rate did not significantly differ between the two groups (29.8% vs. 28.1%, p=0.836; log rank p=0.815) The recurrence rate for atrial tachycardias (17.6% vs. 43.8%, p=0.141) was higher in POBI group, but the cardioversion rates (13.5% vs. 8.5%, p=0.434) were not significantly different between two groups. At the final follow-up, sinus rhythm was maintained without antiarrhythmic drug in 52.6% in CPVI group and 59.7% of POBI group (p=0.452). No significant difference was found in the major complication rates between the two groups (5.3% vs. 1.8%, p=0.618), but the total ablation time was significantly longer in the POBI group (4397±842 sec vs. 5337±1517 sec, p<0.001). Conclusion In patients with persistent AF converted to paroxysmal AF by AAD, the addition of POBI to CPVI did not improve the rhythm outcome of catheter ablation nor influence overall safety. Funding Acknowledgement Type of funding source: None

scholarly journals Electrical Posterior Box Isolation in Persistent Atrial Fibrillation Changed to Paroxysmal Atrial Fibrillation

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Hui-Nam Pak ◽  
Junbeom Park ◽  
Je-Wook Park ◽  
Song-Yi Yang ◽  
Hee Tae Yu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Antiarrhythmic Drug ◽  
Persistent Atrial Fibrillation ◽  
Complication Rates ◽  
Unique Identifier ◽  
Clinical Recurrence ◽  
Ablation Time ◽  
Significant Difference

Background: Persistent atrial fibrillation (AF) can change to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether electrical posterior box isolation (POBI) may improve rhythm outcome of catheter ablation in those patient groups. Methods: We prospectively randomized 114 patients with persistent AF to paroxysmal AF (men, 75%; 59.8±9.9 years old) to circumferential pulmonary vein isolation (CPVI) alone group (n=57) and additional POBI group (n=57). Primary end point was AF recurrence after a single procedure, and secondary end points were recurrence pattern, cardioversion rate, and response to antiarrhythmic drugs. Results: After a mean follow-up of 23.8±10.2 months, the clinical recurrence rate did not significantly differ between the CPVI alone and additional POBI group (31.6% versus 28.1%; P =0.682; log-rank P =0.729). The recurrences as atrial tachycardias (5.3% versus 12.3%; P =0.134) and cardioversion rates (5.3% versus 10.5%; P =0.250) were not significantly different between the CPVI and POBI groups. At the final follow-up, sinus rhythm was maintained without antiarrhythmic drug in 52.6% of CPVI group and 59.6% of POBI group ( P =0.450). No significant difference was found in major complication rates between the two groups (5.3% versus 1.8%; P =0.618), but the total ablation time was significantly longer in the POBI group (4187±952 versus 5337±1517 s; P <0.001). Conclusions: In patients with persistent AF converted to paroxysmal AF by antiarrhythmic drug, the addition of POBI to CPVI did not improve the rhythm outcome of catheter ablation or influence overall safety, while leading to longer ablation time. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02176616.

scholarly journals The Predictive Value of left atrial appendage peak flow velocity in Recurrence after initial radiofrequency catheter ablation of persistent atrial fibrillation: A single-center prospective study.

2021 ◽  
Author(s):  
Wentao Yang ◽  
Qing Zhao ◽  
Minghui Yao ◽  
Xiangdong Li ◽  
Yue Zhang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Flow Velocity ◽  
Left Atrial ◽  
Radiofrequency Catheter Ablation ◽  
Left Atrial Appendage ◽  
Peak Flow ◽  
Persistent Atrial Fibrillation ◽  
Af Recurrence

Background: Recurrence after Radiofrequency catheter ablation（RFCA） of persistent atrial fibrillation (PeAF) is still elusive. The present study aimed to evaluate the relationship between the left atrial appendage peak flow velocity(LAAV) and atrial fibrillation(AF) recurrences in PeAF patients after their initial RFCA. Method: This study included 164 consecutive PeAF patients who performed initial RFCA from January 2018 to December 2019. Transesophageal echocardiography was used to collect the LAAV before ablation. Patients’ demographic and clinical information was gathered. To detect the recurrences of AF, patients were checked up at routine intervals. A Cox proportional hazards regression analysis was adopted to evaluate the LAAV and other clinical variables as predictors of AF recurrences throughout follow-up. Results: AF recurrence resulted in 43 (26.2%) patients after a median follow-up of 15 months (IQR: 12-18 months). LAAV reduced in patients with AF recurrences (0.36±0.15m/s vs. 0.45±0.17m/s, P = 0.004). A Kaplan-Meier study revealed that the low LAAV(≤0.37m/s) group had a lower event-free survival rate than the high LAAV (>0.37m/s) group (17.6 months vs. 21.2 months, Log Rank P = 0.002). LAAV≤0.37m/s (HR 2.32, 95%CI 1.177-4.227, P = 0.014) was found to be independent predictors of AF recurrence after RFCA in the multivariate Cox regression. Conclusion: A low LAAV is linked to AF recurrence and acts as a predictor of AF recurrence after the initial RFCA of peAF. This would aid in treatment strategy optimization and management of patients with peAF.

Sign in / Sign up

Export Citation Format

Share Document