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- Title
Feasibility of catheter ablation in patients with persistent atrial fibrillation guided by fragmented late‐gadolinium enhancement areas.
- Authors
Kiuchi, Kunihiko; Fukuzawa, Koji; Takami, Mitsuru; Watanabe, Yoshiaki; Izawa, Yu; Shigeru, Mayumi; Oonishi, Hiroyuki; Suehiro, Hideya; Akita, Tomomi; Takemoto, Makoto; Yatomi, Atsusuke; Nakamura, Toshihiro; Sakai, Jun; Nakasone, Kazutaka; Sonoda, Yusuke; Yamamoto, Kyoko; Takahara, Hiroyuki; Negi, Noriyuki; Kyotani, Katsusuke; Kono, Atsushi
- Abstract
Background: A computer simulation model has demonstrated that atrial fibrillation (AF) driver can be attached to heterogeneous fibrosis assessed by late gadolinium enhancement magnetic resonance imaging (LGE‐MRI). However, it has not been well elucidated in patients with persistent AF. The aim of this study was to investigate whether radiofrequency (RF) applications in the fragmented LGE area (FLA) could terminate AF or convert it to atrial tachycardia (AT) and improve the rhythm outcome. Methods: A total of 31 consecutive persistent AF patients with FLAs were enrolled (FLA ablation group, mean age: 69 ± 8 years, mean left atrial diameter: 42 ± 6 mm). A favorable response was defined as direct AF termination or AT conversion during RF applications at the FLA. The rhythm outcome was compared between the FLA ablation group and FLA burden‐matched pulmonary vein isolation (PVI) group. Results: Favorable responses were found in 15 (48%) of 31 patients in the FLA group (AF termination in seven, AT conversion in eight patients), but not in the PVI group. AF recurrence at 12 months follow‐up was significantly less in the FLA ablation group than in the PVI group (4 [13%] vs. 12 [39%] of 31 patients, log‐rank p =.023). In patients with a favorable response, AT recurred in 1 (7%) of 15 patients, but AF did not. Conclusions: FLA ablation could terminate AF or convert it to AT in half of the patients. No AF recurrence was documented in patients with a favorable response.
- Subjects
PILOT projects; CLINICAL trials; CATHETER ablation; ATRIAL fibrillation; MAGNETIC resonance imaging; CONTRAST media; SURGERY; PATIENTS; DIAGNOSTIC imaging; TREATMENT effectiveness; COMPARATIVE studies; HEART atrium; TACHYCARDIA; DESCRIPTIVE statistics; PULMONARY veins; LONGITUDINAL method; EVALUATION
- Publication
Journal of Cardiovascular Electrophysiology, 2021, Vol 32, Issue 4, p1014
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.14925