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Electrical Posterior Box Isolation in Repeat Ablation for Atrial Fibrillation: A Prospective Randomized Clinical Study

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dc.contributor.author김대훈-
dc.contributor.author김태훈-
dc.contributor.author박희남-
dc.contributor.author엄재선-
dc.contributor.author유희태-
dc.contributor.author이문형-
dc.contributor.author정보영-
dc.date.accessioned2022-07-08T03:08:57Z-
dc.date.available2022-07-08T03:08:57Z-
dc.date.issued2022-05-
dc.identifier.issn2405-500X-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/188691-
dc.description.abstractObjectives: This study investigated whether additional electrical posterior box isolation (POBI) may improve the rhythm outcome of repeat ablation in atrial fibrillation (AF). Background: Although electrically reconnected pulmonary veins (PVs) are the main mechanism of AF recurrence, it is unclear whether linear ablation in addition to circumferential PV isolation (CPVI) improves rhythm outcomes after repeat ablation. Methods: The authors prospectively randomized 150 patients with PV reconnection undergoing redo procedures to either a CPVI-alone group (n = 75) or an additional POBI group (n = 75). The primary endpoint was AF recurrence after a single procedure, and the secondary endpoints were recurrence pattern, cardioversion rate, and response to antiarrhythmic drugs. Results: After a median follow-up of 17 months, the clinical recurrence rate did not significantly differ between the CPVI-alone and additional-POBI groups (30.7% vs 30.7%; log-rank P =0.828). Of the 46 patients with clinical recurrence, the recurrences as atrial tachycardia (8.7% vs 30.4%; P =0.137) and cardioversion rates (21.7% vs 47.8%; P =0.122) were not significantly different between the CPVI-alone and additional-POBI groups. Major complication rates did not differ between the 2 groups (1.3% vs 5.3%; P = 0.363), but the total ablation time was significantly longer in the additional-POBI group than in the CPVI-alone group (median: 1,084 [IQR: 704-1,664] vs 1,595 [IQR: 1,244-2,302] seconds; P < 0.001). Conclusions: Among patients undergoing redo AF ablation with reconnected PVs, the addition of POBI to CPVI did not improve rhythm outcomes or influence overall safety, whereas leading to a longer ablation time than that with CPVI alone. (Comparison of Circumferential Pulmonary Vein Isolation and Complex Pulmonary Vein Isolation Additional Linear Ablation for Recurred Atrial Fibrillation After Previous Catheter Ablation: Prospective Randomized Trial [RILI Trial]; NCT02747498).-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherElsevier Inc.-
dc.relation.isPartOfJACC. Clinical Electrophysiology-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAtrial Fibrillation* / surgery-
dc.subject.MESHCatheter Ablation* / adverse effects-
dc.subject.MESHCatheter Ablation* / methods-
dc.subject.MESHHumans-
dc.subject.MESHProspective Studies-
dc.subject.MESHPulmonary Veins* / surgery-
dc.subject.MESHRecurrence-
dc.subject.MESHTreatment Outcome-
dc.titleElectrical Posterior Box Isolation in Repeat Ablation for Atrial Fibrillation: A Prospective Randomized Clinical Study-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorDaehoon Kim-
dc.contributor.googleauthorHee Tae Yu-
dc.contributor.googleauthorTae-Hoon Kim-
dc.contributor.googleauthorJae-Sun Uhm-
dc.contributor.googleauthorBoyoung Joung-
dc.contributor.googleauthorMoon-Hyoung Lee-
dc.contributor.googleauthorHui-Nam Pak-
dc.identifier.doi10.1016/j.jacep.2022.01.003-
dc.contributor.localIdA00373-
dc.contributor.localIdA01085-
dc.contributor.localIdA01776-
dc.contributor.localIdA02337-
dc.contributor.localIdA02535-
dc.contributor.localIdA02766-
dc.contributor.localIdA03609-
dc.relation.journalcodeJ03493-
dc.identifier.eissn2405-5018-
dc.identifier.pmid35589170-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S2405500X22000044?via%3Dihub-
dc.subject.keywordatrial fibrillation-
dc.subject.keywordcatheter ablation-
dc.subject.keywordposterior box isolation-
dc.subject.keywordredo ablation-
dc.contributor.alternativeNameKim, Dae Hoon-
dc.contributor.affiliatedAuthor김대훈-
dc.contributor.affiliatedAuthor김태훈-
dc.contributor.affiliatedAuthor박희남-
dc.contributor.affiliatedAuthor엄재선-
dc.contributor.affiliatedAuthor유희태-
dc.contributor.affiliatedAuthor이문형-
dc.contributor.affiliatedAuthor정보영-
dc.citation.volume8-
dc.citation.number5-
dc.citation.startPage582-
dc.citation.endPage592-
dc.identifier.bibliographicCitationJACC. Clinical Electrophysiology, Vol.8(5) : 582-592, 2022-05-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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