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- Title
Catheter ablation approach and outcome in HIV+ patients with recurrent atrial fibrillation.
- Authors
La Fazia, Vincenzo Mirco; Pierucci, Nicola; Mohanty, Sanghamitra; Gianni, Carola; Della Rocca, Domenico Giovanni; Compagnucci, Paolo; MacDonald, Bryan; Mayedo, Angel; Torlapati, Prem Geeta; Bassiouny, Mohamed; Gallinghouse, Gerald Joseph; Burkhardt, John D.; Horton, Rodney; Al‐Ahmad, Amin; Di Biase, Luigi; Natale, Andrea
- Abstract
Introduction: Earlier studies have shown a clear association between severity of human immunodeficiency virus (HIV) infection and incident atrial fibrillation (AF). We present the long‐term outcome of catheter ablation (CA) and electrophysiological characteristics in HIV+ AF patients. Methods: This study evaluated 1438 consecutive AF patients [31 (2.15%) with HIV and 1407 (97.8%) without HIV diagnosis] undergoing their first CA at our center. A total of 31 HIV patients and 31 controls were generated by propensity matching, based on calculated risk factor scores, using a logistic model. During first procedure, all received isolation of pulmonary vein (PV) + posterior wall and superior vena cava. Non‐PV triggers, defined as ectopic triggers originating from sites other than PVs, were identified at the redo ablation with high‐dose isoproterenol challenge. Results: Clinical characteristics were not different between the groups. When compared to the control, by the end of 5 years after the first procedure, recurrence was significantly greater in HIV group [100% vs. 54%, p <.001]. Among patients that underwent redo ablation non‐PV triggers were higher in HIV group [93.5% vs. 54%, p <.001], and most frequently originated from the coronary sinus [67.7% vs. 45.2%, p <.001] and left atrial appendage [41.9% vs. 25.8%, p <.001]. After focal ablation of non‐PV trigger, no difference in arrhythmia recurrence between two groups [80.6% vs. 87.1%, p =.753] at 1‐year follow up was found. Conclusion: Our findings suggest that non‐PV triggers are highly prevalent in HIV+ AF patients resulting in higher rate of the mid‐ and long‐term arrhythmia recurrence.
- Subjects
HIV-positive persons; ISOPROTERENOL; ATRIAL fibrillation; CATHETER ablation; DISEASE relapse; TREATMENT effectiveness; ELECTROPHYSIOLOGY; DESCRIPTIVE statistics; SYMPTOMS; PULMONARY veins; EVALUATION
- Publication
Journal of Cardiovascular Electrophysiology, 2023, Vol 34, Issue 12, p2527
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.16076