Non-pulmonary vein foci induced before and after pulmonary vein isolation in patients undergoing ablation therapy for paroxysmal atrial fibrillation: incidence and clinical outcome

Cao, Hui; Dai, Yin-yin; Jiang, Ruhong; Liu, Qiang; Sun, Yaxun; Jin, Lin; Zhang, Zuwen; Chen, Shiquan; Zhu, Jie; Sheng, Xia; Jiang, Chenyang

doi:10.1631/jzus.b1400146

Cited by 12 publications

(8 citation statements)

References 22 publications

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“…Subsequently, high‐dose isoproterenol (ISP, 5‐15 mcg/min) was intravenously infused. In previous studies, the ISP dose for induction of non‐PV foci varied from 1 to 20 mcg/min, but the appropriate ISP dose was unclear . In this study, we used high‐dose ISP up to 15 mcg/min, which exceeded the physiological ISP dose to unmask the non‐PV foci.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of the nonpulmonary vein foci induced after second‐generation cryoballoon ablation for paroxysmal atrial fibrillation

Kato

Nitta

Satô

et al. 2019

Cardiovasc electrophysiol

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Introduction: Pulmonary vein isolation (PVI) using cryoballoon is effective for patients with paroxysmal atrial fibrillation (PAF); however, few reports have evaluated the non-pulmonary vein (PV) foci after cryoballoon ablation. We aimed to evaluate the characteristics of non-PV foci and predictors of atrial fibrillation (AF) recurrence after cryoballoon ablation. Methods and Results:This was a single-center retrospective study of 647 patients with PAF who underwent initial PVI using a second-generation cryoballoon. After PVI, all patients underwent high-dose isoproterenol infusion to assess the existence of non-PV foci. Non-PV foci were observed in 211 patients (32.6%), which were most frequently observed in the superior vena cava. Higher age (odds ratio [OR] = 1.02; 95% confidence interval [CI] = 1.00-1.04; P = .025), female sex (OR = 1.65; 95% CI = 1.13-2.41; P = .009), and lower body mass index (OR = 0.95; 95% CI = 0.89-1.00; P = .049) were significantly associated with non-PV foci. The existence of non-PV foci was an independent predictor of AF recurrence (Hazard's ratio = 1.70; 95% CI = 1.12-2.60; P = .014). When non-PV foci were mappable and successfully ablated, patients with non-PV foci showed similar outcomes with those without non-PV foci (1-year AF-free survival rates of 88.5% vs 91.5%; P = .338). Conversely, when we failed to detect and eliminate non-PV foci because they had multiple origins and were not consistently inducible (multichanging non-PV foci), the 1-year AF-free survival rate was 56.4% even after substrate modification.Conclusion: Non-PV foci were observed in one-third of patients with PAF after cryoballoon ablation and were associated with AF recurrence. Catheter ablation for non-PV foci was effective when they were mappable; however, multichanging non-PV foci were associated with worse prognosis. K E Y W O R D Scatheter ablation, nonpulmonary vein foci, paroxysmal atrial fibrillation, pulmonary vein isolation, second-generation cryoballoon

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Section: Methodsmentioning

confidence: 99%

Characteristics of the nonpulmonary vein foci induced after second‐generation cryoballoon ablation for paroxysmal atrial fibrillation

Kato

Nitta

Satô

et al. 2019

Cardiovasc electrophysiol

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“…The catheter ablation procedure has been described in our previous publications (Cheng et al, 2014;Jiang et al, 2014). After the RFCA procedure, patients were randomly assigned to the following two groups.…”

Section: Anticoagulation Regimenmentioning

confidence: 99%

Metabolic benefits of rivaroxaban in non-valvular atrial fibrillation patients after radiofrequency catheter ablation

Zhu

Gao

Liu

et al. 2017

J. Zhejiang Univ. Sci. B

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Background and objective: Rivaroxaban is a new oral anticoagulant for stroke prevention in patients with non-valvular atrial fibrillation (NVAF), which has less drug-food interaction than warfarin. We conducted this prospective randomized study to evaluate the metabolic benefits as well as the safety and efficacy with rivaroxaban versus warfarin in patients with NVAF following radiofrequency catheter ablation (RFCA). Methods: From April to July 2014, 60 patients with NVAF undergoing RFCA were prospectively enrolled in our study. Following RFCA, all patients were randomly assigned to receive rivaroxaban (Group R, n=30) or warfarin (Group W, n=30). Metabolic indices including serum total protein, albumin, globulin, and high-density lipoprotein (HDL) as well as bleeding, stroke, and systemic thromboembolism events were evaluated and compared during follow-up after 15, 30, 60, and 90 d of RFCA procedure. Results: Serum total protein, albumin, globulin, and HDL levels were all significantly elevated at each follow-up stage in Group R when compared to the baseline (P<0.05 respectively). In Group W, the metabolic indices decreased at first and then had an increasing trend. There were no deaths or thromboembolic complications in each group. The prevalence of total bleeding complications was similar between Group R and Group W (11/30, 36.7% vs. 10/30, 33.3%, P=0.79). Conclusions: Patients with NVAF receiving rivaroxaban after RFCA procedures appear to benefit from a metabolic perspective compared with warfarin, providing practical clinical reference for the choice of the anticoagulant. Rivaroxaban seems to be as safe and effective in preventing thromboembolic events as warfarin for these patients.

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“…Известно, что частота выявления зон эктопической активности после изоляции легочных вен составляет от 8 до 18% [21,22]. Дополнительные радиочастотные воздействия в данных областях также позволяют повысить отдаленные результаты радиочастотной аблации фибрилляции предсердий [23][24][25].…”

Section: заключениеunclassified

Using adenosine triphosphate in catheter radiofrequency pulmonary vein isolation: does elimination of “dormant” atriovenous conduction really allow to refine long-term results?

Krivosheev¹,

Башта²,

Simonyan³

et al. 2017

PKiK

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This literature review looks at the efficacy of removing “dormant” atriovenous conduction, which can be identified by means of intravenous ejection of adenosine triphosphate following catheter isolation of pulmonary vein ostia in patients with atrial fibrillation. The incidence of detecting conduction “breakthroughs” in the ablation lines when carrying out drug tests after isolation of pulmonary veins, as well as the prognostic significance of this phenomenon for atrial fibrillation recurrence are evaluated. Also assessed are drawbacks and limitations of the studies looking at the possibility of improving the efficiency of catheter ablation of atrial fibrillation by combining the removal of “dormant” atriovenous conduction zones identified by adenosine triphosphate testing and the ablation of ganglionated plexi.Received 10 April 2017. Accepted 23 October 2017.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and study design: Y.S. Krivosheev, V.N. Kolesnikov. Data collection and analysis: Y.S. Krivosheev, D.I. Bashta. Drafting the article: Y.S. Krivosheev, A.A. Simonyan. Critical revision of the article: V.N. Kolesnikov. Final approval of the version to be published: Y.S. Krivosheev, D.I. Bashta, A.A. Simonyan, T.A. Myznikova, Z.A. Mishodzheva, V.N. Kolesnikov.

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Non-pulmonary vein foci induced before and after pulmonary vein isolation in patients undergoing ablation therapy for paroxysmal atrial fibrillation: incidence and clinical outcome

Cited by 12 publications

References 22 publications

Characteristics of the nonpulmonary vein foci induced after second‐generation cryoballoon ablation for paroxysmal atrial fibrillation

Characteristics of the nonpulmonary vein foci induced after second‐generation cryoballoon ablation for paroxysmal atrial fibrillation

Metabolic benefits of rivaroxaban in non-valvular atrial fibrillation patients after radiofrequency catheter ablation

Using adenosine triphosphate in catheter radiofrequency pulmonary vein isolation: does elimination of “dormant” atriovenous conduction really allow to refine long-term results?

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