98 232

Cited 0 times in

Does additional linear ablation after circumferential pulmonary vein isolation improve clinical outcome in patients with paroxysmal atrial fibrillation? Prospective randomised study.

Authors
 Hee-Sun Mun  ;  Boyoung Joung  ;  Jaemin Shim  ;  Hye Jin Hwang  ;  Jong Youn Kim  ;  Moon-Hyoung Lee  ;  Hui-Nam Pak 
Citation
 HEART, Vol.98(6) : 480-484, 2012 
Journal Title
 HEART 
ISSN
 1355-6037 
Issue Date
2012
MeSH
Atrial Fibrillation/surgery* ; Cardiac Surgical Procedures/methods ; Catheter Ablation/methods* ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Veins/surgery* ; Treatment Outcome
Keywords
Atrial Fibrillation/surgery* ; Cardiac Surgical Procedures/methods ; Catheter Ablation/methods* ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Veins/surgery* ; Treatment Outcome
Abstract
OBJECTIVE: Circumferential pulmonary vein isolation (CPVI) has been considered the cornerstone of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). However, it is unclear whether linear ablation in addition to CPVI improves clinical outcome. DESIGN: Prospective randomised study to compare the efficacy of CPVI and CPVI with additional linear ablation in patients with paroxysmal AF (PAF). SETTING: University hospital. PATIENTS: This study enrolled 156 patients (male 76.3%, 55.8±11.5 years old (mean±SD)) who underwent RFCA for PAF. INTERVENTIONS: CPVI (n=52), CPVI+roof line (CPVI+RL; n=52) and CPVI+RL+posterior inferior line (CPVI+PostBox; n=52). MAIN OUTCOME MEASURES: Procedure time, ablation time and clinical outcome. RESULTS: (1) The CPVI group showed shorter total procedure time (180.4±39.5 min vs 189.6±29.0 min and 201.7±51.7 min, respectively (mean±SD); p=0.035) and ablation time (4085.5±1384.1 s vs 5253.5±1010.9 s and 5495.0±1316.0 s, respectively; p<0.001) than the CPVI+RL and CPVI+PostBox groups. (2) During 15.6±5.0 months of follow-up, the recurrence rates 3 months after RFCA were 11.5% in CPVI, 21.2% in CPVI+RL and 19.2% in CPVI+PostBox (p=0.440). (3) The achievement rate of CPVI was 100.0%, and bidirectional block rate was 80.8% in CPVI+RL and 59.6% in CPVI+PostBox. The clinical recurrence rates with or without achieving bidirectional block were not significantly different from each other (p=0.386). CONCLUSION: In patients with PAF, linear ablation in addition to CPVI did not improve clinical outcome, regardless of bidirectional block achievement, while it prolonged the total procedure and ablation time.
Files in This Item:
T201201707.pdf Download
DOI
22285969
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jong Youn(김종윤) ORCID logo https://orcid.org/0000-0001-7040-8771
Mun, Hee Sun(문희선)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Shim, Jae Min(심재민)
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Hwang, Hye Jin(황혜진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90344
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse