Ablation of persistent atrial fibrillation and beyond

Lin, Yenn Jiang; Lin, Chin Yu; Chen, Shih Ann

doi:10.1097/hco.0000000000000575

Cited by 1 publication

(2 citation statements)

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“…2 For the unstable and chaotic properties of complex AF signals, phase mapping could provide spatial and temporal information that helps to reveal the electrical properties of the atrial matrix, and offering additional insight into AF mechanisms. 6 Using a novel electrogram similarity analysis and real-time phase mapping to identify the rotors/drivers, we have previously reported, from a randomized trial of patients with persistent AF, a lower AF recurrence rate using adjuvant rotor/ driver ablation when compared with CFAE ablation, after PVI. 7 This finding suggested that additional ablation for the rotors/drivers after PVI guided by nonlinear phase maps improves the SR outcome.…”

Section: Introductionmentioning

confidence: 99%

“…In the STAR AF 2 trial, the lack of benefits in maintaining sinus rhythm (SR) with either additional linear or CFAE ablation compared to PVI only raised the concern that additional ablation after PVI might not be feasible in patients with persistent AF 2 . For the unstable and chaotic properties of complex AF signals, phase mapping could provide spatial and temporal information that helps to reveal the electrical properties of the atrial matrix, and offering additional insight into AF mechanisms 6 . Using a novel electrogram similarity analysis and real‐time phase mapping to identify the rotors/drivers, we have previously reported, from a randomized trial of patients with persistent AF, a lower AF recurrence rate using adjuvant rotor/driver ablation when compared with CFAE ablation, after PVI 7 .…”

Section: Introductionmentioning

confidence: 99%

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Optimal substrate modification strategies using catheter ablation in patients with persistent atrial fibrillation: 3‐year follow‐up outcomes

Hsieh

Lin

et al. 2021

Cardiovasc electrophysiol

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Objectives This study aimed to assess the comparative efficacy of four ablation strategies on the incidence rates of freedom from atrial fibrillation (AF) or atrial tachycardia (AT) through a 3‐year follow‐up in patients with persistent AF. Background The optimal substrate modification strategies using catheter ablation for patients with persistent AF remain unclear. Methods Patients with persistent AF were enrolled consecutively to undergo each of four ablation strategies: (a) Group 1 (Gp 1, n = 69), pulmonary vein isolation (PVI) plus rotor ablation assisted by similarity index and phase mapping; (b) Gp 2 (n = 75), PVI plus linear ablations at the left atrium; (c) Gp 3 (n = 42), PVI plus the elimination of complex fractionated atrial electrograms; (d) Gp 4 (n = 67), PVI only. Potential confounders were adjusted via a multivariate survival parametric model. Results Baseline characteristics were similar across the four groups. At a follow‐up period of 34.9 ± 38.6 months, patients in Gp 1 showed the highest rate of freedom from AF compared with the other three groups (p = .002), while patients in Gp 3 and 4 showed lower rates of freedom from AT than those of the other two groups (p = .006). Independent predictors of recurrence of AF were the ablation strategy (p = .002) and left atrial diameter (LAD) (p = .01). Conclusion In patients with persistent AF, a substrate modification strategy using rotor ablation assisted by similarity index and phase mapping provided a benefit for maintaining sinus rhythm compared with the other strategies. Both ablation strategy and baseline LAD predicted the 3‐year outcomes of freedom from AT/AF

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Section: Introductionmentioning

confidence: 99%