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Additional linear ablation from the superior vena cava to right atrial septum after pulmonary vein isolation improves the clinical outcome in patients with paroxysmal atrial fibrillation: prospective randomized study.

DC FieldValueLanguage
dc.contributor.author이문형-
dc.contributor.author정보영-
dc.contributor.author박준범-
dc.contributor.author박진규-
dc.contributor.author박희남-
dc.contributor.author엄재선-
dc.date.accessioned2015-12-28T10:59:49Z-
dc.date.available2015-12-28T10:59:49Z-
dc.date.issued2014-
dc.identifier.issn1099-5129-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/138470-
dc.description.abstractAIMS: Although circumferential pulmonary vein isolation (CPVI) has been considered as the cornerstone for paroxysmal atrial fibrillation (PAF) ablation, there has been a substantial recurrence rate. We conducted a prospectively randomized study to evaluate whether additional linear ablation from the superior vena cava (SVC) to the right atrial (RA) septum (SVC-L) improves the clinical outcome. METHODS AND RESULTS: This study enroled 200 patients with PAF (male 74.5%, 56.8 ± 11.7 years old) randomly assigned to either the CPVI (n = 100) or CPVI + SVC-L (n = 100) groups. An RA isthmus ablation was performed in all patients. The CPVI + SVC-L group required a longer ablation procedure time (82.7 ± 17.9 min) than the CPVI group (63.6 ± 16.8 min, P < 0.001). The complication rates were 5% in CPVI + SVC-L group and 2% in CPVI group, respectively (P = 0.445). Two CPVI + SVC-L group patients had post-procedural sinus node dysfunction, which recovered within 24 h. During 12.2 ± 5.3 months of follow-up, the recurrence rate was significantly lower in the CPVI + SVC-L group (6%) than the CPVI group (27%, P < 0.001). The post-procedural 3-month follow-up heart rate variability in the CPVI + SVC-L group showed a significantly greater reduction in the rMSSD (25.2 ± 13.7 vs. 13.7 ± 8.5 ms, P < 0.001), HF (10.2 ± 7.1 vs. 5.5 ± 5.8 ms(2), P < 0.001), and LF/HF (1.6 ± 0.5 vs. 0.9 ± 0.3, P < 0.001) than in the CPVI group. CONCLUSION: In spite of a longer procedure time and risk of transient sinus node dysfunction, an SVC-L in addition to CPVI improved the clinical outcome of catheter ablation, and was associated with post-procedural autonomic neural remodelling in patients with PAF.-
dc.description.statementOfResponsibilityopen-
dc.format.extent1738~1745-
dc.relation.isPartOfEUROPACE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAtrial Fibrillation/diagnosis*-
dc.subject.MESHAtrial Fibrillation/surgery*-
dc.subject.MESHAtrial Septum/surgery*-
dc.subject.MESHBody Surface Potential Mapping-
dc.subject.MESHCatheter Ablation/methods*-
dc.subject.MESHFemale-
dc.subject.MESHHeart Conduction System/surgery*-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHProspective Studies-
dc.subject.MESHPulmonary Veins/surgery*-
dc.subject.MESHSurgery, Computer-Assisted/methods-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHVena Cava, Superior/surgery*-
dc.titleAdditional linear ablation from the superior vena cava to right atrial septum after pulmonary vein isolation improves the clinical outcome in patients with paroxysmal atrial fibrillation: prospective randomized study.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorKi Woon Kang-
dc.contributor.googleauthorHui Nam Pak-
dc.contributor.googleauthorJunbeom Park-
dc.contributor.googleauthorJin Gyu Park-
dc.contributor.googleauthorJae Sun Uhm-
dc.contributor.googleauthorBoyoung Joung-
dc.contributor.googleauthorMoon Hyoung Lee-
dc.contributor.googleauthorChun Hwang-
dc.identifier.doi10.1093/europace/euu226-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA02766-
dc.contributor.localIdA03609-
dc.contributor.localIdA01670-
dc.contributor.localIdA01697-
dc.contributor.localIdA01776-
dc.contributor.localIdA02337-
dc.relation.journalcodeJ00801-
dc.identifier.eissn1532-2092-
dc.identifier.pmid25336668-
dc.identifier.urlhttp://europace.oxfordjournals.org/content/16/12/1738-
dc.subject.keywordCatheter ablation-
dc.subject.keywordParoxysmal atrial fibrillation-
dc.subject.keywordRecurrence-
dc.subject.keywordSuperior vena cava-
dc.contributor.alternativeNameLee, Moon Hyoung-
dc.contributor.alternativeNameJoung, Bo Young-
dc.contributor.alternativeNamePark, Jun Beom-
dc.contributor.alternativeNamePark, Jin Kyu-
dc.contributor.alternativeNamePak, Hui Nam-
dc.contributor.alternativeNameUhm, Jae Sun-
dc.contributor.affiliatedAuthorLee, Moon Hyoung-
dc.contributor.affiliatedAuthorJoung, Bo Young-
dc.contributor.affiliatedAuthorPark, Jun Beom-
dc.contributor.affiliatedAuthorPark, Jin Kyu-
dc.contributor.affiliatedAuthorPak, Hui Nam-
dc.contributor.affiliatedAuthorUhm, Jae Sun-
dc.rights.accessRightsfree-
dc.citation.volume16-
dc.citation.number12-
dc.citation.startPage1738-
dc.citation.endPage1745-
dc.identifier.bibliographicCitationEUROPACE, Vol.16(12) : 1738-1745, 2014-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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