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Clinical Usefulness of Computational Modeling-Guided Persistent Atrial Fibrillation Ablation: Updated Outcome of Multicenter Randomized Study
DC Field | Value | Language |
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dc.contributor.author | 김인수 | - |
dc.contributor.author | 김태훈 | - |
dc.contributor.author | 박희남 | - |
dc.contributor.author | 엄재선 | - |
dc.contributor.author | 유희태 | - |
dc.contributor.author | 이문형 | - |
dc.contributor.author | 임병현 | - |
dc.contributor.author | 정보영 | - |
dc.contributor.author | 황민기 | - |
dc.date.accessioned | 2020-06-04T08:38:55Z | - |
dc.date.available | 2020-06-04T08:38:55Z | - |
dc.date.issued | 2019-12 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/175828 | - |
dc.description.abstract | Objective: Catheter ablation of persistent atrial fibrillation (AF) is still challenging, no optimal extra-pulmonary vein lesion set is known. We previously reported the clinical feasibility of computational modeling-guided AF catheter ablation. Methods: We randomly assigned 118 patients with persistent AF (77.8% men, age 60.8 ± 9.9 years) to the computational modeling-guided ablation group (53 patients) and the empirical ablation group (55 patients) based on the operators' experience. For virtual ablation, four virtual linear and one electrogram-guided lesion sets were tested on patient heart computed tomogram-based models, and the lesion set with the fastest termination time was reported to the operator in the modeling-guided ablation group. The primary outcome was freedom from atrial tachyarrhythmias lasting longer than 30 s after a single procedure. Results: During 31.5 ± 9.4 months, virtual ablation procedures were available in 95.2% of the patients (108/118). Clinical recurrence rate was significantly lower after a modeling-guided ablation than after an empirical ablation (20.8 vs. 40.0%, log-rank p = 0.042). Modeling-guided ablation was independently associated with a better long-term rhythm outcome of persistent AF ablation (HR = 0.29 [0.12-0.69], p = 0.005). The rhythm outcome of the modeling-guided ablation showed better trends in males, non-obese patients with a less remodeled atrium (left atrial dimension < 50 mm), ejection fraction ≥ 50%, and those without hypertension or diabetes (p < 0.01). There were no significant differences between the groups for the total procedure time (p = 0.403), ablation time (p = 0.510), and major complication rate (p = 0.900). Conclusion: Among patients with persistent AF, the computational modeling-guided ablation was superior to the empirical catheter ablation regarding the rhythm outcome. Clinical trial registration: This study was registered with the ClinicalTrials.gov, number NCT02171364. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Frontiers Research Foundation | - |
dc.relation.isPartOf | FRONTIERS IN PHYSIOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Clinical Usefulness of Computational Modeling-Guided Persistent Atrial Fibrillation Ablation: Updated Outcome of Multicenter Randomized Study | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | In-Soo Kim | - |
dc.contributor.googleauthor | Byounghyun Lim | - |
dc.contributor.googleauthor | Jaemin Shim | - |
dc.contributor.googleauthor | Minki Hwang | - |
dc.contributor.googleauthor | Hee Tae Yu | - |
dc.contributor.googleauthor | Tae-Hoon Kim | - |
dc.contributor.googleauthor | Jae-Sun Uhm | - |
dc.contributor.googleauthor | Sung-Hwan Kim | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.contributor.googleauthor | Young Keun On | - |
dc.contributor.googleauthor | Seil Oh | - |
dc.contributor.googleauthor | Yong-Seog Oh | - |
dc.contributor.googleauthor | Gi-Byung Nam | - |
dc.contributor.googleauthor | Moon-Hyoung Lee | - |
dc.contributor.googleauthor | Eun Bo Shim | - |
dc.contributor.googleauthor | Young-Hoon Kim | - |
dc.contributor.googleauthor | Hui-Nam Pak | - |
dc.contributor.googleauthor | CUVIA-AF1 Investigators | - |
dc.identifier.doi | 10.3389/fphys.2019.01512 | - |
dc.contributor.localId | A00840 | - |
dc.contributor.localId | A01085 | - |
dc.contributor.localId | A01776 | - |
dc.contributor.localId | A02337 | - |
dc.contributor.localId | A02535 | - |
dc.contributor.localId | A02766 | - |
dc.contributor.localId | A05396 | - |
dc.contributor.localId | A03609 | - |
dc.contributor.localId | A04459 | - |
dc.relation.journalcode | J02868 | - |
dc.identifier.eissn | 1664-042X | - |
dc.identifier.pmid | 31920716 | - |
dc.subject.keyword | atrial fibrillation | - |
dc.subject.keyword | catheter ablation | - |
dc.subject.keyword | computational modeling | - |
dc.subject.keyword | recurrence | - |
dc.subject.keyword | virtual ablation | - |
dc.contributor.alternativeName | Kim, In-Soo | - |
dc.contributor.affiliatedAuthor | 김인수 | - |
dc.contributor.affiliatedAuthor | 김태훈 | - |
dc.contributor.affiliatedAuthor | 박희남 | - |
dc.contributor.affiliatedAuthor | 엄재선 | - |
dc.contributor.affiliatedAuthor | 유희태 | - |
dc.contributor.affiliatedAuthor | 이문형 | - |
dc.contributor.affiliatedAuthor | 임병현 | - |
dc.contributor.affiliatedAuthor | 정보영 | - |
dc.contributor.affiliatedAuthor | 황민기 | - |
dc.citation.volume | 10 | - |
dc.citation.startPage | e1512 | - |
dc.identifier.bibliographicCitation | FRONTIERS IN PHYSIOLOGY, Vol.10 : e1512, 2019-12 | - |
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