Optimal single procedure strategy of pulmonary vein isolation with cryoballoon or radiofrequency and non-pulmonary vein triggers ablation for non-paroxysmal atrial fibrillation

Nitta, Giichi; Nitta, Junichi; Inaba, Osamu; Satô, Akira; Inamura, Yukihiro; Tomomasa, Takeshi; Goya, Masahiko; Sasano, Tetsuo

doi:10.1016/j.ijcha.2022.101021

IJC Heart & Vasculature

2022

DOI: 10.1016/j.ijcha.2022.101021

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Optimal single procedure strategy of pulmonary vein isolation with cryoballoon or radiofrequency and non-pulmonary vein triggers ablation for non-paroxysmal atrial fibrillation

Giichi Nitta

Junichi Nitta

Osamu Inaba

et al.

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“…The knowledge about concomitant risk factors such as SDB status in AF patients is important to approximate success rates of interventions [20] , [21] , [22] , [23] . AF ablation is effective and safe in obese and diabetic patients with and without SDB [24] , [25] , [26] , [27] . Observational studies and meta -analyses showed that appropriate SDB treatment may improve rhythm control in AF patients [28] .…”

mentioning

confidence: 99%

Recent highlights on the prevalence and role of sleep disordered breathing in cardiovascular diseases from the International Journal of Cardiology Heart & Vasculature

Linz,

Dobrev

2023

IJC Heart & Vasculature

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mentioning

confidence: 99%

Recent highlights on the prevalence and role of sleep disordered breathing in cardiovascular diseases from the International Journal of Cardiology Heart & Vasculature

Linz,

Dobrev

2023

IJC Heart & Vasculature

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Impact of Atrial Fibrillation Triggers on Long-Term Outcomes of a Second Catheter Ablation of Nonparoxysmal Atrial Fibrillation

Shinohara,

Fujino,

Wada

et al. 2024

Circ Rep

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Background: Catheter ablation (CA) of atrial fibrillation (AF) triggers, including non-pulmonary vein (PV) foci, contributes to improved procedural outcomes. However, the clinical significance of an AF trigger ablation during second CA procedures for nonparoxysmal AF is unknown. Methods and Results: We enrolled 94 patients with nonparoxysmal AF undergoing a second CA. Intracardiac cardioversion during AF using high-dose isoproterenol was performed to determine the presence or absence of AF triggers. PV re-isolations were performed if PV potentials recurred, and if AF triggers appeared from any non-PV sites, additional ablation was added to those sites. We investigated the incidence of atrial arrhythmia recurrence (AAR) >3 months post-CA. Of the 94 enrolled patients, AF triggers were identified in 65 (69.1%), and of those with AF triggers, successful elimination of the triggers was achieved in 47 patients (72.3%). Multivariate analysis revealed that no observed AF triggers were a significant predictor of AAR (hazard ratio [HR] 1.97, 95% confidence interval [CI] 1.21–3.46, P=0.019). In a subanalysis of the patients with AF triggers, multivariate analysis showed that unsuccessful trigger ablation was significantly associated with AAR (HR 5.84, 95% CI 2.79–12.22, P<0.01). Conclusions: Having no observed AF triggers during a second CA session significantly increased the risk of AAR, as did unsuccessful CA of AF triggers.

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Optimal single procedure strategy of pulmonary vein isolation with cryoballoon or radiofrequency and non-pulmonary vein triggers ablation for non-paroxysmal atrial fibrillation

Cited by 2 publications

References 30 publications

Recent highlights on the prevalence and role of sleep disordered breathing in cardiovascular diseases from the International Journal of Cardiology Heart & Vasculature

Recent highlights on the prevalence and role of sleep disordered breathing in cardiovascular diseases from the International Journal of Cardiology Heart & Vasculature

Impact of Atrial Fibrillation Triggers on Long-Term Outcomes of a Second Catheter Ablation of Nonparoxysmal Atrial Fibrillation

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