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Virtual In-Silico Modeling Guided Catheter Ablation Predicts Effective Linear Ablation Lesion Set for Longstanding Persistent Atrial Fibrillation: Multicenter Prospective Randomized Study

DC FieldValueLanguage
dc.contributor.author김태훈-
dc.contributor.author박희남-
dc.contributor.author임병현-
dc.contributor.author정보영-
dc.date.accessioned2018-07-20T08:42:37Z-
dc.date.available2018-07-20T08:42:37Z-
dc.date.issued2017-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/161371-
dc.description.abstractObjective: Radiofrequency catheter ablation for persistent atrial fibrillation (PeAF) still has a substantial recurrence rate. This study aims to investigate whether an AF ablation lesion set chosen using in-silico ablation (V-ABL) is clinically feasible and more effective than an empirically chosen ablation lesion set (Em-ABL) in patients with PeAF. Methods: We prospectively included 108 patients with antiarrhythmic drug-resistant PeAF (77.8% men, age 60.8 ± 9.9 years), and randomly assigned them to the V-ABL (n = 53) and Em-ABL (n = 55) groups. Five different in-silico ablation lesion sets [1 pulmonary vein isolation (PVI), 3 linear ablations, and 1 electrogram-guided ablation] were compared using heart-CT integrated AF modeling. We evaluated the feasibility, safety, and efficacy of V-ABL compared with that of Em-ABL. Results: The pre-procedural computing time for five different ablation strategies was 166 ± 11 min. In the Em-ABL group, the earliest terminating blinded in-silico lesion set matched with the Em-ABL lesion set in 21.8%. V-ABL was not inferior to Em-ABL in terms of procedure time (p = 0.403), ablation time (p = 0.510), and major complication rate (p = 0.900). During 12.6 ± 3.8 months of follow-up, the clinical recurrence rate was 14.0% in the V-ABL group and 18.9% in the Em-ABL group (p = 0.538). In Em-ABL group, clinical recurrence rate was significantly lower after PVI+posterior box+anterior linear ablation, which showed the most frequent termination during in-silico ablation (log-rank p = 0.027). Conclusions: V-ABL was feasible in clinical practice, not inferior to Em-ABL, and predicts the most effective ablation lesion set in patients who underwent PeAF ablation.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherFrontiers Research Foundation-
dc.relation.isPartOfFrontiers in Physiology-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleVirtual In-Silico Modeling Guided Catheter Ablation Predicts Effective Linear Ablation Lesion Set for Longstanding Persistent Atrial Fibrillation: Multicenter Prospective Randomized Study-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Internal Medicine-
dc.contributor.googleauthorJaemin Shim-
dc.contributor.googleauthorMinki Hwang-
dc.contributor.googleauthorJun-Seop Song-
dc.contributor.googleauthorByounghyun Lim-
dc.contributor.googleauthorTae-Hoon Kim-
dc.contributor.googleauthorBoyoung Joung-
dc.contributor.googleauthorSung-Hwan Kim-
dc.contributor.googleauthorYong-Seog Oh-
dc.contributor.googleauthorGi-Byung Nam-
dc.contributor.googleauthorYoung Keun On-
dc.contributor.googleauthorSeil Oh-
dc.contributor.googleauthorYoung-Hoon Kim-
dc.contributor.googleauthorHui-Nam Pak-
dc.identifier.doi10.3389/fphys.2017.00792-
dc.contributor.localIdA01085-
dc.contributor.localIdA01776-
dc.contributor.localIdA05396-
dc.contributor.localIdA03609-
dc.relation.journalcodeJ02868-
dc.identifier.eissn1664-042X-
dc.identifier.pmid29075201-
dc.subject.keywordatrial fibrillation-
dc.subject.keywordcatheter ablation-
dc.subject.keywordin-silico modeling-
dc.subject.keywordrecurrence-
dc.subject.keywordvirtual ablation-
dc.contributor.alternativeNameKim, Tae Hoon-
dc.contributor.alternativeNamePak, Hui Nam-
dc.contributor.alternativeNameLim, Byounghyun-
dc.contributor.alternativeNameJoung, Bo Young-
dc.contributor.affiliatedAuthorKim, Tae-Hoon-
dc.contributor.affiliatedAuthorPak, Hui Nam-
dc.contributor.affiliatedAuthorLim, Byounghyun-
dc.contributor.affiliatedAuthorJoung, Bo Young-
dc.citation.volume8-
dc.citation.startPage792-
dc.identifier.bibliographicCitationFrontiers in Physiology, Vol.8 : 792, 2017-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers

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