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Atrial electroanatomical remodeling as a determinant of different outcomes between two current ablation strategies: circumferential pulmonary vein isolation vs pulmonary vein isolation

DC FieldValueLanguage
dc.contributor.author정보영-
dc.contributor.author황혜진-
dc.contributor.author김성순-
dc.contributor.author김진배-
dc.contributor.author이문형-
dc.contributor.author이병호-
dc.contributor.author이정명-
dc.contributor.author장양수-
dc.date.accessioned2015-04-23T17:04:46Z-
dc.date.available2015-04-23T17:04:46Z-
dc.date.issued2010-
dc.identifier.issn0160-9289-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/101782-
dc.description.abstractBACKGROUND: The purpose of this study was to investigate the relationship between the efficacy of the 2 different ablation techniques of atrial fibrillation (AF) and left atrial (LA) size. METHODS AND RESULTS: A total of 81 patients with paroxysmal AF (n = 58) or persistent AF (n = 23) refractory to antiarrhythmic drugs underwent circumferential pulmonary vein isolation (PVI; n = 45) or PVI (n = 36) without respect to echocardiographic results for LA volume index (LAVI). Of the 81 patients, 41 had less dilated LA (group 1; LAVI < 27 cc/m(2)) and 40 had dilated LA (group 2; LAVI > or = 27 cc/m(2)). During the 9-month follow-up, 33 patients (73.3%) after circumferential PVI and 18 (50%) after PVI (P = .031) were free of arrhythmia. The risk of recurrence was associated with persistent AF, hypertension, LAVI > 27 ml/m(2), PVI, early recurrence of AF, and lower left ventricular (LV) ejection fraction (all P value <.05). In the univariate analysis of each group, PVI (hazard ratio [HR]: 2.92, 95% confidence interval [CI]: 0.12-7.08, P = .018) was associated with late recurrence only in group 2. Cox regression analysis also showed that PVI (HR: 5.6, 95% CI: 1.9-16.56, P = .002) was a significant independent predictor of recurrence only in group 2. CONCLUSIONS: Circumferential PVI is more effective than PVI only in patients with a structural change of the atria, that is, a dilated LA. Our study suggests that a successful outcome in dilated LA may depend on wide modification of LA electroanatomical substrates, but wide ablation in less dilated LA may be unnecessary. Different technical strategies according to LA size are required for more a effective outcome.-
dc.description.statementOfResponsibilityopen-
dc.format.extentE69~E74-
dc.relation.isPartOfCLINICAL CARDIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAtrial Fibrillation/mortality-
dc.subject.MESHAtrial Fibrillation/therapy*-
dc.subject.MESHCatheter Ablation*-
dc.subject.MESHConfidence Intervals-
dc.subject.MESHFemale-
dc.subject.MESHHeart Atria/pathology*-
dc.subject.MESHHeart Rate-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMultivariate Analysis-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHProspective Studies-
dc.subject.MESHPulmonary Veins/pathology-
dc.subject.MESHPulmonary Veins/surgery*-
dc.subject.MESHRecurrence-
dc.subject.MESHRisk Factors-
dc.subject.MESHStroke Volume-
dc.subject.MESHTreatment Outcome*-
dc.subject.MESHVentricular Function, Left-
dc.titleAtrial electroanatomical remodeling as a determinant of different outcomes between two current ablation strategies: circumferential pulmonary vein isolation vs pulmonary vein isolation-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorHye Jin Hwang-
dc.contributor.googleauthorJung Myung Lee-
dc.contributor.googleauthorBoyoung Joung-
dc.contributor.googleauthorByung-Ho Lee-
dc.contributor.googleauthorJin-Bae Kim-
dc.contributor.googleauthorMoon-Hyoung Lee-
dc.contributor.googleauthorYangsoo Jang-
dc.contributor.googleauthorSung Soon Kim-
dc.identifier.doi10.1002/clc.20567-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA03609-
dc.contributor.localIdA04496-
dc.contributor.localIdA00573-
dc.contributor.localIdA01016-
dc.contributor.localIdA02766-
dc.contributor.localIdA03099-
dc.contributor.localIdA03448-
dc.contributor.localIdA02800-
dc.relation.journalcodeJ00565-
dc.identifier.eissn1932-8737-
dc.identifier.pmid20127901-
dc.identifier.urlhttp://onlinelibrary.wiley.com/doi/10.1002/clc.20567/abstract-
dc.contributor.alternativeNameJoung, Bo Young-
dc.contributor.alternativeNameHwang, Hye Jin-
dc.contributor.alternativeNameKim, Sung Soon-
dc.contributor.alternativeNameKim, Jin Bae-
dc.contributor.alternativeNameLee, Moon Hyoung-
dc.contributor.alternativeNameLee, Byung Ho-
dc.contributor.alternativeNameLee, Jung Myung-
dc.contributor.alternativeNameJang, Yang Soo-
dc.contributor.affiliatedAuthorJoung, Bo Young-
dc.contributor.affiliatedAuthorHwang, Hye Jin-
dc.contributor.affiliatedAuthorKim, Sung Soon-
dc.contributor.affiliatedAuthorKim, Jin Bae-
dc.contributor.affiliatedAuthorLee, Moon Hyoung-
dc.contributor.affiliatedAuthorLee, Jung Myung-
dc.contributor.affiliatedAuthorJang, Yang Soo-
dc.contributor.affiliatedAuthorLee, Byung Ho-
dc.citation.volume33-
dc.citation.number3-
dc.citation.startPage69-
dc.citation.endPage74-
dc.identifier.bibliographicCitationCLINICAL CARDIOLOGY, Vol.33(3) : 69-74, 2010-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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