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Does Additional Electrogram-Guided Ablation After Linear Ablation Reduce Recurrence After Catheter Ablation for Longstanding Persistent Atrial Fibrillation? A Prospective Randomized Study
DC Field | Value | Language |
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dc.contributor.author | 김종윤 | - |
dc.contributor.author | 김태훈 | - |
dc.contributor.author | 박희남 | - |
dc.contributor.author | 엄재선 | - |
dc.contributor.author | 이문형 | - |
dc.contributor.author | 정보영 | - |
dc.date.accessioned | 2017-11-02T08:19:12Z | - |
dc.date.available | 2017-11-02T08:19:12Z | - |
dc.date.issued | 2017 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/154330 | - |
dc.description.abstract | BACKGROUND: Although circumferential pulmonary vein isolation (CPVI) catheter ablation may not be sufficient for long-standing persistent atrial fibrillation (L-PeAF), it is not clear which ablation strategy is beneficial in addition to CPVI. We sought to investigate whether additional complex fractionated atrial electrogram (CFAE)-guided ablation improves clinical outcomes in L-PeAF patients who exhibit continuous atrial fibrillation (AF) after CPVI and linear ablation (Line). METHODS AND RESULTS: This study enrolled 137 L-PeAF patients (71.4% male, 61.6±10.9 years old) who underwent radiofrequency catheter ablation. We conducted CPVI+Line based on the Dallas lesion set (posterior box+anterior line) after baseline CFAE mapping in all patients. If AF was defragmented (terminated or changed to atrial tachycardia), the procedure was stopped (AF-Defrag group, n=29). If AF was maintained after CPVI+Line, we mapped the CFAE again and randomly assigned the patient to the CPVI+Line group (n=54) or the additional CFAE ablation group (CPVI+Line+CFAE group, n=54). L-PeAF was defragmented during CPVI+Line in 21.2% of patients (29/137, AF-Defrag group). The mean CFAE cycle length was prolonged (P<0.001), and CFAE area (CFAE cycle length <120 milliseconds) was reduced (P<0.001) after CPVI+Line in the remaining patients. Procedure time was longer in the CPVI+Line+CFAE group than the CPVI+Line group (P=0.023), but procedure-related complication rates did not vary. During 22.3±13.2 months of follow-up, the clinical recurrence rates were 17.2% in the AF-Defrag group, 18.5% in the CPVI+Line group, and 32.1% in the CPVI+Line+CFAE group (log rank, P=0.166). CONCLUSIONS: Although CPVI+Line reduces and localizes CFAE area, additional CFAE ablation after CPVI+Line does not improve the clinical outcomes of catheter ablation in patients with L-PeAF. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | Wiley-Blackwell | - |
dc.relation.isPartOf | JOURNAL OF THE AMERICAN HEART ASSOCIATION | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Atrial Fibrillation/physiopathology | - |
dc.subject.MESH | Atrial Fibrillation/surgery* | - |
dc.subject.MESH | Catheter Ablation/methods* | - |
dc.subject.MESH | Electrophysiologic Techniques, Cardiac/methods* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Follow-Up Studies | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Prospective Studies | - |
dc.subject.MESH | Pulmonary Veins | - |
dc.subject.MESH | Recurrence | - |
dc.subject.MESH | Secondary Prevention/methods* | - |
dc.subject.MESH | Time Factors | - |
dc.subject.MESH | Treatment Outcome | - |
dc.title | Does Additional Electrogram-Guided Ablation After Linear Ablation Reduce Recurrence After Catheter Ablation for Longstanding Persistent Atrial Fibrillation? A Prospective Randomized Study | - |
dc.type | Article | - |
dc.publisher.location | England | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Internal Medicine | - |
dc.contributor.googleauthor | Tae‐Hoon Kim | - |
dc.contributor.googleauthor | Jae‐Sun Uhm | - |
dc.contributor.googleauthor | Jong‐Youn Kim | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.contributor.googleauthor | Moon‐Hyoung Lee | - |
dc.contributor.googleauthor | Hui‐Nam Pak | - |
dc.identifier.doi | 10.1161/JAHA.116.004811 | - |
dc.contributor.localId | A01085 | - |
dc.contributor.localId | A01776 | - |
dc.contributor.localId | A02337 | - |
dc.contributor.localId | A02766 | - |
dc.contributor.localId | A03609 | - |
dc.contributor.localId | A00926 | - |
dc.relation.journalcode | J01774 | - |
dc.identifier.eissn | 2047-9980 | - |
dc.identifier.pmid | 28174170 | - |
dc.identifier.url | http://jaha.ahajournals.org/content/6/2/e004811.long | - |
dc.subject.keyword | ablation | - |
dc.subject.keyword | atrial fibrillation | - |
dc.subject.keyword | catheter ablation | - |
dc.subject.keyword | complex fractionated atrial electrogram ablation | - |
dc.subject.keyword | linear ablation | - |
dc.subject.keyword | persistent atrial fibrillation | - |
dc.contributor.alternativeName | Kim, Jong Youn | - |
dc.contributor.alternativeName | Kim, Tae Hoon | - |
dc.contributor.alternativeName | Pak, Hui Nam | - |
dc.contributor.alternativeName | Uhm, Jae Sun | - |
dc.contributor.alternativeName | Lee, Moon Hyoung | - |
dc.contributor.alternativeName | Joung, Bo Young | - |
dc.contributor.affiliatedAuthor | Kim, Tae-Hoon | - |
dc.contributor.affiliatedAuthor | Pak, Hui Nam | - |
dc.contributor.affiliatedAuthor | Uhm, Jae Sun | - |
dc.contributor.affiliatedAuthor | Lee, Moon Hyoung | - |
dc.contributor.affiliatedAuthor | Joung, Bo Young | - |
dc.contributor.affiliatedAuthor | Kim, Jong Youn | - |
dc.citation.title | Journal of the American Heart Association | - |
dc.citation.volume | 6 | - |
dc.citation.number | 2 | - |
dc.citation.startPage | 00481 | - |
dc.identifier.bibliographicCitation | JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol.6(2) : 00481, 2017 | - |
dc.date.modified | 2017-11-01 | - |
dc.identifier.rimsid | 42899 | - |
dc.type.rims | ART | - |
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