scholarly journals Inflammatory Response after Different Ablation Strategies for Paroxysmal Atrial Fibrillation

2020 ◽  
Vol 23 (5) ◽  
pp. E703-E711
Author(s):  
Guangli Yin ◽  
Bofei Ma ◽  
Bolun Zhou ◽  
Jinglan Wu ◽  
Ling You ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Inflammatory Response ◽  
Recurrence Rate ◽  
Paroxysmal Atrial Fibrillation ◽  
White Blood Cells ◽  
Time Points ◽  
Ambulatory Electrocardiography ◽  
Before And After ◽  
Af Recurrence

Background: Catheter ablation for atrial fibrillation (AF) has been gaining popularity; however, the trend of inflammatory response markers in patients treated with different catheter ablation strategies over time and their predictability of AF recurrence remain unknown. Methods: A total of 210 patients with AF were enrolled and grouped according to surgical mode as follows: freeze group, RF group, and freeze3D group. The subjects were tested for related indexes before and after surgery. To determine AF recurrence during follow up, 24-h ambulatory electrocardiography was performed at two, three, six, and 12 months after surgery. Results: The inflammation indexes of the three groups peaked between one and three days after surgery but fell at different time points (P < .05). The recurrence rate of paroxysmal atrial fibrillation (PAF) was positively correlated with the increase in the percentage of white blood cells and neutrophils after surgery (P < .05). Conclusions: The postoperative inflammation indices peaked and fell at different time points after different catheter ablation methods. In addition, the recurrence rate of AF in patients treated with freeze3D is lower.

Advanced Interatrial Block in Patients with Paroxysmal Atrial Fibrillation Before and After Catheter Ablation

2019 ◽  
Vol 53 ◽  
pp. e21
Author(s):  
Elena Blinova ◽  
Tamara Sakhnova ◽  
Oleg Sapelnikov ◽  
Dmitriy Cherkashin ◽  
Renat Akchurin
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Before And After ◽  
Interatrial Block

Advanced Interatrial Block in Patients with Paroxysmal Atrial Fibrillation Before and After Catheter Ablation

2018 ◽  
Vol 51 (6) ◽  
pp. 1182-1183
Author(s):  
Elena Blinova ◽  
Tamara Sakhnova ◽  
Oleg Sapelnikov ◽  
Dmitriy Cherkashin ◽  
Renat Akchurin
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Before And After ◽  
Interatrial Block

Abstract 2161: Left Atrium Reverse Remodeling After Pulmonary Vein Isolation. Will It Be a Predictor for Non-recurrence of Atrial Fibrillation?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
kiyotake Ishikawa ◽  
Yukihiko Yoshida ◽  
Sumio Morita ◽  
Kenji Furusawa ◽  
Noriyoshi Kanemura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Reverse Remodeling ◽  
Transverse Diameter ◽  
Before And After ◽  
History Of ◽  
Af Recurrence

Background: Left atrium (LA) dilation plays an important role in development and persistence of atrial fibrillation (AF). Some cases show structural reverse remodeling of LA after catheter ablation of AF. The aim of this study was to assess the clinical significance of LA reverse remodeling. Method and Results: Echocardiographic data before and after ablation was obtained in 173 cases who underwent pulmonary vein isolation from January 2006 to April 2008 (74.0% men, 61.0±11 years old; paroxysmal AF 114, persistent AF 34, permanent AF 25). Mean atrial diameter before ablation was 39.0±6.1mm (paroxysmal 37.7±5.6mm, persistent 40.7±5.3mm, and permanent 43.0±6.8mm) and LA reverse remodeling was defined as 10% decrement of LA transverse diameter. Half of the cases were taking anti-arrhythmic drugs after ablation, and AF recurrence occurred in 16.8% (29/173) during mean follow up period of 8.5±6.3 months. Reverse remodeling of LA was seen in 34.1% (59/173) and AF recurrence rate in this group was 11.9% (7/59), whereas 19.3% (22/114) without reverse remodeling (P=0.29). However, limited in patients with LA diameter over 40mm (44.5%; 77/173), 3.2% (1/31) of AF recurrence was seen in those with reverse remodeling, while 21.7% (10/46) without reverse remodeling (P=0.04). LA reverse remodeling was observed significantly frequent in patients without history of hypertension(41.5% without hypertension vs 25.6% with hypertension, P=0.036). Conclusion: LA reverse remodeling after catheter ablation of AF in dilated LA patient is a simple and useful predictor for non-recurrence of AF. Hypertension could be a disturbance for LA reverse remodeling.

scholarly journals Radiofrequency vs. Cryoballoon Catheter Ablation for Paroxysmal Atrial Fibrillation: Durability of Pulmonary Vein Isolation and Effect on AF Burden: The RACE-AF Randomized Controlled Trial

2021 ◽  
Author(s):  
Samuel K. Sørensen ◽  
Arne Johannessen ◽  
René Worck ◽  
Morten L. Hansen ◽  
Jim Hansen
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Paroxysmal Atrial Fibrillation ◽  
Controlled Trial ◽  
Pulmonary Veins ◽  
Primary Methods ◽  
Second Procedure ◽  
Af Recurrence

Background - Recurrent paroxysmal atrial fibrillation (PAF) after catheter ablation is presumably caused by failure to achieve durable pulmonary vein isolation (PVI). The primary methods of PVI are radiofrequency (RF) and cryoballoon (CRYO) catheter ablation, but these methods have not been directly compared with respect to PVI durability and the effect thereof on AF burden (% of time in AF). Methods - Accordingly, we performed a randomized trial including 98 patients (68% male, 61 [55-67] years) with PAF assigned 1:1 to PVI by contact-force sensing, irrigated RF catheter or second-generation CRYO catheter. Implantable cardiac monitors were inserted ≥1 month before PVI for assessment of AF burden and recurrence, and all patients, irrespective of AF recurrence, underwent a second procedure 4-6 months after PVI to determine PVI durability. Results - In the second procedure, 152/199 (76%) pulmonary veins (PVs) were found durably isolated after RF and 161/200 (81%) after CRYO (NS), corresponding to durable isolation of all veins in 47% of patients in both groups (NS). Median AF burden before PVI was 5.4% (interquartile range: 0.5-13.0%) vs. 4.0% (0.6-18.1%), RF vs. CRYO, and reduced to 0.0% (0.0-0.1%) and 0.0% (0.0-0.5%), respectively - a reduction of 99.9% (92.9-100.0%) and 99.3% (85.9-100.0%) (all NS). AF burden after PVI significantly correlated to the number of durably isolated PVs (p < 0.01), but 9/45 (20%) patients with durable isolation of all veins had recurrence of AF within 4-6 months after PVI (excluding a 3-month blanking period). Conclusions - PVI by RF and CRYO catheter ablation produce similar moderate to high PVI durability. Both treatments lead to marked reductions in AF burden, which is related to the number of durably isolated PVs. However, for one fifth of PAF patients, complete and durable PVI was not sufficient to prevent even short-term AF recurrence.

Abstract 12449: The Electrocardiogram Left Ventricular Hypertrophy With Strain Pattern Predicts Recurrence in Paroxysmal Atrial Fibrillation Patients After Radiofrequency Catheter Ablation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Lu Wang ◽  
Song-Nan Li ◽  
Mohamed Salim ◽  
Zhe Wang ◽  
Wang-Yang Yang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Ventricular Hypertrophy ◽  
Paroxysmal Atrial Fibrillation ◽  
Radiofrequency Catheter Ablation ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Point System ◽  
Strain Pattern ◽  
Af Recurrence

Introduction: The present of left ventricular hypertrophy (LVH) or LVH with strain pattern on electrocardiogram (ECG) are independently predictors of new-onset atrial fibrillation (AF). Hypothesis: We assessed the hypothesis that LVH with or without strain can predict recurrence after radiofrequency catheter ablation (RFCA) of AF in paroxysmal atrial fibrillation (PAF) patients. Methods: 436 PAF patients undergoing RFCA were enrolled and clustered into 3 subgroups: Non-LVH (218 patients), LVH (182 patients), LVH with strain (36 patients). LVH was characterized by the Romhilt-Estes point system and ECG strain was defined as ST-segment depression≥1-mm and T-wave inversion≥1 mm in the lateral leads. Results: After 42 (interquartile range, 18.0 to 60.0 months) months follow-up period with a median of 1 (1 to 3) RFCA procedure, sinus rhythm was maintained in 248 patients (60.2%) without antiarrhythmic drugs. Patients with LVH (79, 43.6%) and LVH with strain (22, 62.9%) tended to experience much higher AF episodes recurrence ratio compared to those with non-LVH (71, 33.3%; P=0.000). In multivariate analysis after adjustment for age, sex, CHA2SDVAS score and left atrial diameter (LAD), the present of LVH with strain was the only independent risk factor of AF recurrence (95%CI: 1.242 to 5.808, P=0.012). Conclusions: That present of LVH with strain but not LVH alone is a strong and independent predictor of AF recurrence in PAF patients following RFCA.

Non-paroxysmal atrial fibrillation mapping: characterization of the electrophysiological substrate using a novel integrated mapping technique

EP Europace ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1193-1202
Author(s):  
Giuseppe Ciconte ◽  
Gabriele Vicedomini ◽  
Wenwen Li ◽  
Jan O Mangual ◽  
Luke McSpadden ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Mapping Technique ◽  
Wavefront Propagation ◽  
Bipolar Voltage ◽  
Before And After ◽  
Underlying Mechanisms

Abstract Aims Clinical outcomes after radiofrequency catheter ablation (RFCA) remain suboptimal in the treatment of non-paroxysmal atrial fibrillation (AF). Electrophysiological mapping may improve understanding of the underlying mechanisms. To describe the arrhythmia substrate in patients with persistent (Pers) and long-standing persistent (LSPers) AF, undergoing RFCA, using an integrated mechanism mapping technique. Methods and results Patients underwent high-density electroanatomical mapping before and after catheter ablation. Integrated maps characterized electrogram (EGM) cycle length (CL) in regions with repetitive–regular (RR) activations, stable wavefront propagation, fragmentation, and peak-to-peak bipolar voltage. Among 83 patients (72% male, 60 ± 11 years old), RR activations were identified in 376 regions (mean CL 180 ± 31 ms). PersAF patients (n = 43) showed more RR sites per patient (5.3 ± 2.4 vs. 3.7 ± 2.1, P = 0.002) with faster CL (166 ± 29 vs. 190 ± 29 ms; P < 0.001) and smaller surface area of fragmented EGMs (15 ± 14% vs. 27 ± 17%, P < 0.001) compared with LSPersAF. The post-ablation map in 50 patients remaining in AF, documented reduction of the RR activities per patient (1.5 ± 0.7 vs. 3.7 ± 1.4, P < 0.001) and area of fragmentation (22 ± 17% vs. 8 ± 9%, P < 0.001). Atrial fibrillation termination during ablation occurred at RR sites (0.48 ± 0.24 mV; 170.5 ± 20.2 ms CL) in 31/33 patients (94%). At the latest follow-up, arrhythmia freedom was higher among patients receiving ablation >75% of RR sites (Q4 82.6%, Q3 63.1%, Q2 35.1%, and Q1 0%; P < 0.001). Conclusion The integrated mapping technique allowed characterization of multiple arrhythmic substrates in non-paroxysmal AF patients. This technique might serve as tool for a substrate-targeted ablation approach.

scholarly journals Impact of corrected sinus node recovery time in predicting recurrence in patients with paroxysmal atrial fibrillation

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110101
Author(s):  
Zhi-Song Chen ◽  
Hong-Wei Tan ◽  
Hao-Ming Song ◽  
Wen-Jun Xu ◽  
Xue-Bo Liu
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Recovery Time ◽  
Radiofrequency Catheter Ablation ◽  
Sinus Node ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Sinus Node Recovery Time ◽  
Af Recurrence

Objective Atrial fibrillation (AF) and sinus node dysfunction (SND) have common underlying pathophysiological mechanisms. As an index of SND, corrected sinus node recovery time (CSNRT) may also reflect atrial function. The aim of the present study was to determine whether CSNRT predicts AF recurrence in patients undergoing AF ablation. Methods Consecutive patients with paroxysmal atrial fibrillation (PAF) who underwent radiofrequency catheter ablation between January 2017 and December 2018 were enrolled. Clinical data, CSNRT, and other electrophysiology indices were collected and analysed between patients with or without AF recurrence. Results A total of 159 patients with PAF who underwent the same radiofrequency catheter ablation procedure were enrolled, including 25 patients with SND. During the one-year follow-up period, 22 patients experienced AF recurrence. Patients with recurrence had a significantly longer CSNRT and a larger left atrial volume index (LAVI) than patients without AF recurrence. SND (CSNRT > 550 ms) and a larger LAVI were independently associated with AF recurrence after ablation. A statistically significant CSNRT cut-off value of 550 ms predicted AF recurrence with 73% sensitivity and 85% specificity. Conclusion CSNRT and LAVI are independent predictors of PAF recurrence following ablation.

Efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with atrial septal defect: a comparison with transcatheter closure alone

EP Europace ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. 1663-1669 ◽  
Author(s):  
Koji Nakagawa ◽  
Teiji Akagi ◽  
Satoshi Nagase ◽  
Yoichi Takaya ◽  
Yasufumi Kijima ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Atrial Septal Defect ◽  
Paroxysmal Atrial Fibrillation ◽  
Treatment Strategy ◽  
Septal Defect ◽  
Kaplan Meier ◽  
Asd Closure ◽  
Af Recurrence

Abstract Aims There is no valid treatment strategy for addressing paroxysmal atrial fibrillation (AF) in patients with unclosed atrial septal defect (ASD). We aimed to assess the efficacy of catheter ablation (CA) compared with transcatheter ASD closure alone for treating pre-existing paroxysmal AF in patients with ASD. Methods and results Among 908 patients who underwent transcatheter ASD closure, we evaluated 50 consecutive patients (63 ± 12 years) with paroxysmal AF. We compared the AF outcomes of these patients after transcatheter ASD closure between those with and without CA prior to ASD closure. Thirty (60%) patients underwent CA. During the follow-up period after ASD closure (mean: 49 ± 23 months), recurrence of AF was observed in 6/30 (20%) patients with upfront CA and 12/20 (60%) patients with ASD closure alone. Kaplan–Meier analysis showed that the AF-free survival rate was significantly higher for patients with CA than for those with ASD closure alone (79% vs. 37% at 5 years, P = 0.002). Upfront CA and previous heart failure hospitalization were associated with recurrence of AF after ASD closure [hazard ratio (HR) 0.18, 95% confidence interval (CI) 0.06–0.53; P = 0.002 and HR 4.64, 95% CI 1.60–13.49; P = 0.005, respectively]. Conclusion In ASD patient with paroxysmal AF, transcatheter ASD closure alone demonstrated high AF recurrence rate after ASD closure. On the other hand, upfront CA prior to ASD closure substantially suppressed AF recurrence over the long term. A combination of CA and transcatheter ASD closure may be a feasible treatment strategy for paroxysmal AF in patients with ASD.

Sign in / Sign up

Export Citation Format

Share Document