Early recurrence of atrial fibrillation after catheter ablation with left atrial fibrosis identified at cardiac magnetic resonance by late gadolinium enhancement

Totaro, Antonio; Casavecchia, Graziapia; Gravina, Matteo; Ieva, Riccardo; Santoro, Francesco; Grimaldi, Massimo; Pellegrino, Pier Luigi; Macarini, Luca; Brunetti, Natale Daniele

doi:10.1177/1753944715623232

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Interestingly, as we further explored the possible predictors, only LA diameter (HR adj = 1.067(1.028, 1.107)) and AF type (HR adj = 1.726(1.056, 2.822)) could significantly predict AF recurrence, which is in accordance with previous reports. Based on current knowledge, the contribution of comorbidities to the progression of AF is most likely the result of atrial remodeling and substrate modification, such as fibrosis . However, age and related comorbidities are sufficient but not necessary to modify the atrial substrate in every patient within a short follow‐up period.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of cryoballoon ablation for Chinese patients over 75 years old: A comparison with a younger cohort

Zhang

Ren

Wang

et al. 2019

Cardiovasc electrophysiol

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Introduction Cryoballoon ablation (CBA) results in satisfactory outcomes for drug‐resistant atrial fibrillation (AF) patients. However, the efficacy and safety of CBA have not yet been tested in the Chinese elderly population. Therefore, this study compared the recurrence of AF and complications of CBA in patients ≥75 years and <75 years. Methods A total of 677 patients (<75 years, n = 550; ≥ 75 years, n = 127) with paroxysmal (n = 603) or persistent (n = 74) non‐valvular drug‐resistant AF were included. The efficacy was assessed by the recurrence of AF, and the safety was evaluated by peri‐ and post‐procedural complications. Results The CHA2DS2‐VASc (2.6 ± 1.7 vs 4.8 ± 1.6, P < .01) and HAS‐BLED (1.8 ± 0.8 vs 2.0 ± 0.8, P = .01) scores were significantly higher in the elderly group. The instant pulmonary vein isolation success rate was comparable (99.11% younger vs 98.98% older, P = .99). After a mean follow‐up time of 12.8 ± 9.6 months, the 1‐year freedom from AF rate was 80.6% vs 85.8% in the older and younger groups, respectively, while the survival analysis showed a nonsignificant difference in the rate of freedom from AF (log‐rank P = .46). Cox regression showed that age was not a predictive factor for AF recurrence and was not dichotomized (hazard ratio [HR] = 0.868, 95% confidence interval [CI] 0.509‐1.481; P = .6046) or continuous (HR = 0.990, 95% CI, 0.968‐1.012, P = .3642). Similar complications rates were observed, including stroke (1.0% younger vs 0.93% older, P = .95) and major hemorrhagic events (1.2% younger vs 0% elder, P = .25). Conclusions The efficacy and safety profiles of CBA in patients older than 75 years are comparable with those in younger patients.

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Section: Discussionmentioning

confidence: 99%