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Pulmonary Vein Isolation Alone Versus Additional Linear Ablation in Patients with Persistent Atrial Fibrillation Converted to Paroxysmal Type with Antiarrhythmic Drug Therapy: A Multicenter, Prospective, Randomized Study

Title
Pulmonary Vein Isolation Alone Versus Additional Linear Ablation in Patients with Persistent Atrial Fibrillation Converted to Paroxysmal Type with Antiarrhythmic Drug Therapy: A Multicenter, Prospective, Randomized Study
Authors
Yu H.T.Shim J.Park J.Kim I.-S.Kim T.-H.Uhm J.-S.Joung B.Lee M.-H.Kim Y.-H.Pak H.-N.
Ewha Authors
박준범
SCOPUS Author ID
박준범scopus
Issue Date
2017
Journal Title
Circulation: Arrhythmia and Electrophysiology
ISSN
1941-3149JCR Link
Citation
vol. 10, no. 6
Keywords
antiarrhythmic drugatrial fibrillationcatheter ablationpersistent atrial fibrillationrecurrent event
Publisher
Lippincott Williams and Wilkins
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background - Atrial fibrillation (AF) type can vary depending on condition and timing, and some patients who initially present with persistent AF may be changed to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether circumferential pulmonary vein isolation (CPVI) alone is an effective rhythm control strategy in patients with persistent AF to paroxysmal AF. Methods and Results - We enrolled 113 patients with persistent AF to paroxysmal AF (male 75%, 60.4±10.1 years old) who underwent catheter ablation for nonvalvular AF at 3 tertiary hospitals. The participants were randomly assigned to 2 groups: CPVI alone (n=59) or CPVI plus linear ablation (CPVI+Line; posterior box+anterior line, n=54). Compared with the CPVI+Line, CPVI alone required shorter procedure (187.2±58.0 versus 211.2±63.9 min; P=0.043) and ablation times (4922.1±1110.5 versus 6205.7±1425.2 s; P<0.001) without difference in procedure-related major complication (3% versus 2%; P=0.611). Antiarrhythmic drug utility rates after ablation were not different between the 2 groups (22% versus 30%; P=0.356). Overall, AF-free survival (log-rank; P=0.206) and AF and antiarrhythmic drug-free survival (log-rank; P=0.321) were not different between groups. Conclusions - CPVI alone is an effective rhythm control strategy with a shorter procedure time in persistent AF patients converted to paroxysmal AF compared with CPVI with linear ablation. © 2017 American Heart Association, Inc.
DOI
10.1161/CIRCEP.116.004915
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의과대학 > 의학과 > Journal papers
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