Ganglionated plexi ablation vs linear ablation in patients undergoing pulmonary vein isolation for persistent/longstanding persistent atrial fibrillation: a randomized comparison

Покушалов, Е А; Romanov, Alexander; Katritsis, Demosthenes G.; Artyomenko, Sergey; Shirokova, Natalya; Karaskov, Alexander; Mittal, Suneet; Steinberg, Jonathan S.

doi:10.1093/eurheartj/eht309.2808

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 The same could be said for GP ablation with or without CPVI. A very recent randomized study for catheter ablation in patients with persistent/long-standing persistent AF 20 compared CPVI and additional linear lesions with GP ablation plus CPVI. Although the 3-year follow-up showed a superior result for a single procedure, in the latter group, the best outcome was 49%.…”

Section: Follow-up Results Of Catheter Ablation For Afmentioning

confidence: 99%

GP or No GP, Is That the Question?

Scherlag

2013

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Section: Follow-up Results Of Catheter Ablation For Afmentioning

confidence: 99%

GP or No GP, Is That the Question?

Scherlag

2013

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

“…Recurrence of arrhythmia following catheter ablation for longstanding persistent AF may be mediated by additional arrhythmia drivers outside the pulmonary veins. The posterior left atrial wall in particular harbours rotors, focal drivers, complex fractionated electrograms (CFEs) and a significant concentration of ganglionated plexi in adjacent epicardial fat, and targeted ablation of these substrates has been associated with improved maintenance of sinus rhythm (7)(8)(9)(10)(11). In addition, the mismatch in elasticity between the posterior left atrial wall and the pericardium may promote interstitial fibrosis as an additional trigger for AF, further emphasising the posterior wall as a desirable target for endocardial and epicardial ablation (12)(13).…”

Section: Introductionmentioning

confidence: 99%

The convergent procedure versus catheter ablation alone in longstanding persistent atrial fibrillation: A single centre, propensity-matched cohort study

Maclean

Yap

Saberwal

et al. 2020

International Journal of Cardiology

View full text Add to dashboard Cite

BACKGROUND: Maintenance of sinus rhythm is challenging in patients with longstanding persistent atrial fibrillation (PeAF). Minimally invasive surgical AF ablation may improve outcomes when combined with catheter ablation (the 'convergent' procedure). This study evaluates the safety and efficacy of the convergent procedure versus catheter ablation alone in longstanding PeAF. METHODS: 43 consecutive patients with longstanding PeAF underwent subxiphoid endoscopic ablation of the posterior left atrium followed by catheter ablation from 2013-2018. The primary outcome was AF-free survival at 12 months; secondary outcomes included change in EHRA class, echocardiographic data, procedural complications, freedom from anti-arrhythmic drugs (AADs), and long term arrhythmia-free survival. Outcomes were compared with a matched group of 43 patients who underwent catheter ablation alone. Both groups underwent multiple catheter ablations as required. Baseline characteristics were similar between groups. RESULTS: After 12 months, the convergent procedure was associated with increased AF-free survival on AADs (60.5 % versus 25.6%, p=0.002) and off AADs (37.2% versus 13.9%, p=0.025), versus catheter ablation. Allowing for multiple procedures, after 30.5±13.3 months' follow-up the convergent procedure was associated with increased arrhythmia-free survival on AADs (58.1% versus 30.2%, p=0.016) and off AADs (32.5% versus 11.6%, p=0.036) versus catheter ablation. There were more complications in the convergent procedure group (11.6% versus 2.3%, p=0.2). Multivariate analysis identified only the convergent procedure (OR 3.06 (1.23-7.6), p=0.017) as predictive of arrhythmiafree survival long term. CONCLUSIONS: In longstanding PeAF, the convergent procedure is associated with improved arrhythmia-free survival versus catheter ablation alone. Complication rates are significant but have been shown to depreciate with experience.

show abstract

Ganglionated plexi ablation vs linear ablation in patients undergoing pulmonary vein isolation for persistent/longstanding persistent atrial fibrillation: a randomized comparison

Cited by 2 publications

References 0 publications

GP or No GP, Is That the Question?

GP or No GP, Is That the Question?

The convergent procedure versus catheter ablation alone in longstanding persistent atrial fibrillation: A single centre, propensity-matched cohort study

Contact Info

Product

Resources

About