Atrial Tachycardias After Atrial Fibrillation Ablation: How to Manage?

Hung, Yuan; Chang, Shih Lin; Wang, Lin; Lin, Wen Yu; Chen, Shih Ann

doi:10.15420/aer.2020.07

Cited by 16 publications

(8 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study also showed that the HPSD method could not reduce the risk of recurrent AFL or AT. This result could be caused by several factors: (i) different arrhythmogenic mechanisms, (ii) some patients received not only PVI, and (iii) AFL or AT could be caused by scar formation due to RFCA 51,53 …”

Section: Discussionmentioning

confidence: 99%

The superiority of high‐power short‐duration radiofrequency catheter ablation strategy for atrial fibrillation treatment: A systematic review and meta‐analysis study

Waranugraha

Rizal

Firdaus

et al. 2021

Journal of Arrhythmia

View full text Add to dashboard Cite

Background Radiofrequency catheter ablation (RFCA) using the high‐power short duration (HPSD) results in better ablation lesion formation in the swine model. This systematic review and meta‐analysis purposed to investigate the safety and efficacy profile between HPSD and low‐power long‐duration (LPLD) ablation strategies to treat atrial fibrillation (AF) patients. Methods We completed the literature review after identifying the relevant articles comparing HPSD and LPLD ablation methods for AF recorded in ClinicalTrials.com, CENTRAL, PubMed, and ScienceDirect until February 2021. The overall effects were calculated using pooled risk ratio (RR) and mean difference (MD) for categorical and continuous data, respectively. We also estimated the 95% confidence interval (CI). Results The HPSD strategy took shorter procedure time (MD = −33.75 min; 95% CI = −44.54 to −22.97; P < .01), fluoroscopy time (MD = −5.73 min; 95% CI = −8.77 to −2.70; P < .001), and ablation time (MD = −17.71; 95% CI = −21.02 to −14.41) than LPLD strategy. The HPSD RFCA was correlated with lower risk of esophageal thermal injury (RR = 0.75; 95% CI = 0.59 to 0.94; P = .02). The HPSD method resulted in higher first‐pass pulmonary vein isolation (PVI) (RR = 1.36; 95% CI = 1.13 to 1.64; P < .01), lower PV reconnection (RR = 0.47; 95% CI = 0.34 to 0.64; P < .01), and lower recurrent AF (RR = 0.72; 95% CI = 0.54 to 0.96; P = .02) than LPLD strategy. Conclusion HPSD RFCA was superior to the conventional LPLD RFCA in terms of safety and efficacy in treating AF patients.

show abstract

Section: Discussionmentioning

confidence: 99%

The superiority of high‐power short‐duration radiofrequency catheter ablation strategy for atrial fibrillation treatment: A systematic review and meta‐analysis study

Waranugraha

Rizal

Firdaus

et al. 2021

Journal of Arrhythmia

View full text Add to dashboard Cite

show abstract

“…Not only recurrent AF requires redo ablation, but atypical atrial flutter and atrial tachycardia after AF ablation also lead to redoing ablation in up to 8% of cases. 52,53 The low recurrence rate of those AAs beyond the blanking period reflects the higher success rate of AF ablation. FPI is another outcome that represented the efficacy of AF ablation.…”

Section: Major Complicationsmentioning

confidence: 99%

Network meta‐analysis and systematic review comparing efficacy and safety between very high power short duration, high power short duration, and conventional radiofrequency ablation of atrial fibrillation

Tokavanich

Prasitlumkum

Kewcharoen

et al. 2023

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Background High‐power short‐duration (HPSD) atrial fibrillation (AF) ablation with a power of 40–50 W was proved to be safe and effective. Very high‐power short‐duration (vHPSD) AF ablation is a novel method using >50 W to obtain more durable AF ablation. This study aimed to evaluate the efficacy and safety of vHPSD ablation compared with HPSD ablation and conventional power ablation. Methods A literature search for studies that reported AF ablation outcomes, including short‐term freedom from atrial arrhythmia, first‐pass isolation (FPI) rate, procedure time, and major complications, was conducted utilizing MEDLINE, EMBASE, and Cochrane databases. All relevant studies were included in this analysis. A random‐effects model of network meta‐analysis and surface under cumulative ranking curve (SUCRA) were used to rank the treatment for all outcomes. Results A total of 29 studies with 9721 patients were included in the analysis. According to the SUCRA analysis, HPSD ablation had the highest probability of maintaining sinus rhythm. Point estimation showed an odds ratio of 1.5 (95% confidence interval [CI]: 1.2–1.9) between HPSD ablation and conventional power ablation and an odds ratio of 1.3 (95% CI: 0.78–2.2) between vHPSD ablation and conventional power ablation. While the odds ratio of FPI between HPSD ablation and conventional power ablation was 3.6 (95% CI: 1.5–8.9), the odds ratio between vHPSD ablation and conventional power ablation was 2.2 (95% CI: 0.61–8.6). The procedure times of vHPSD and HPSD ablations were comparable and, therefore, shorter than that of conventional power ablation. Major complications were low in all techniques. Conclusion vHPSD ablation did not yield higher efficacy than HPSD ablation and conventional power ablation. With the safety concern, vHPSD ablation outcomes were comparable with those of other techniques.

show abstract

“…In addition, the patient's history of recent AF ablation was key in diagnosing the arrhythmia, as the incidence of AT post AF ablation is 5 Mobitz 40%. 2,3 There are various causes of aberrated conduction: (1) pre-existing and/or physiologic/functional bundle branch or interventricular conduction block, (2) metabolic derangements (i.e., hyperkalemia), and (3) druginduced (i.e., propafenone toxicity). 4 The described mechanisms of functional/physiologic block include acceleration-dependent block above the critical heart rate, phase 3 block of the action potential, phase 4 bradycardia-dependent block due to disease in the His-Purkinje system, and transseptal, retrograde, concealed invasion of the bundle branch (BB) rendering it refractory to subsequent depolarizations.…”

Section: Commentarymentioning

confidence: 99%

Diagnosing a wide complex tachycardia using basic electrophysiologic properties of the cardiac conduction system

Siroky

Mehta

2021

Journal of Arrhythmia

View full text Add to dashboard Cite

show abstract

Atrial Tachycardias After Atrial Fibrillation Ablation: How to Manage?

Cited by 16 publications

References 71 publications

The superiority of high‐power short‐duration radiofrequency catheter ablation strategy for atrial fibrillation treatment: A systematic review and meta‐analysis study

The superiority of high‐power short‐duration radiofrequency catheter ablation strategy for atrial fibrillation treatment: A systematic review and meta‐analysis study

Network meta‐analysis and systematic review comparing efficacy and safety between very high power short duration, high power short duration, and conventional radiofrequency ablation of atrial fibrillation

Diagnosing a wide complex tachycardia using basic electrophysiologic properties of the cardiac conduction system

Contact Info

Product

Resources

About