Termination of Long‐Lasting Persistent Versus Short‐Lasting Persistent and Paroxysmal Atrial Fibrillation by Ablation

Fiala, Martin; Chovančík, Jan; Nevřalová, Renáta; Neuwirth, Radek; Jiravský, Otakar; Januška, Jaroslav; Branny, Marian

doi:10.1111/j.1540-8159.2008.01126.x

Cited by 36 publications

(33 citation statements)

References 43 publications

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“…The method of catheter ablation has been described in detail elsewher [15][16] . Briefly, ablation consisted of mandatory pulmonary vein isolation with wide circumferential lesions.…”

Section: Catheter Ablationmentioning

confidence: 99%

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Chovančík

Bůlková²,

Wichterle

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. Optimal ECG monitoring in detecting recurrences of atrial fibrillation (AF) or atrial tachycardia (AT) after catheter ablation has not been well established. The purpose of this prospective study was to compare the utility of daily ECG monitoring with episodic card recorder (ECR) vs. periodic monitoring with episodic loop recorder (ELR) for the detection of post-blanking AF/AT recurrences during early (Months 4-6) and late (Months 7-12) periods after catheter ablation for paroxysmal AF. Methods. The study included 105 consecutive patients, who received ECR for 12 months and were instructed to send at least 2 random ECG recordings daily with extra-recordings during symptoms. The patients were simultaneously monitored for one week with ELR at the end of each period (Months 6 and 12). Results. Thirty-one and 12 patients with AF/AT recurrence were identified by means of ECR and ELR, respectively. In patients with complete and valid data, ELR technology was inferior to ECR by detecting AF/AT in 5 (31%) of 16 and 5 (26%) of 19 patients with arrhythmia identified by ECR in the early and late period, respectively. Overall, ELR had a sensitivity of 8/23 (35%) for detecting AF/AT recurrence. There was no single patient with AF/AT recurrence on ELR that would not be known from ECR monitoring. Only 2 patients with arrhythmia recurrence were completely asymptomatic throughout the study period. Conclusion. Daily ECG monitoring with ECR was better than periodic monitoring with ELR in detecting AF/AT recurrences during the follow-up periods. Entirely asymptomatic patients with AF/AT recurrences were rare.

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“…The method of catheter ablation has been described in detail elsewher [15][16] . Briefly, ablation consisted of mandatory pulmonary vein isolation with wide circumferential lesions.…”

Section: Catheter Ablationmentioning

confidence: 99%

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Chovančík

Bůlková²,

Wichterle

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

Self Cite

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“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In these studies, both increased single procedural success 3,5,8,10,[13][14][15][16]19,21 and overall clinical success with multiple procedures 2,6,7,[11][12][13][15][16][17]20,21 were reported when compared with patients who did not achieve AF termination. In a study by Rostock et al, 22 which evaluated the long-term predictors of single-and multiple-procedure outcomes for 395 patients who had undergone persistent AF ablation, AF termination during the index procedure significantly predicted single-procedure success and also a favorable outcome after the final procedure.…”

Section: Circ Arrhythm Electrophysiolmentioning

confidence: 99%

Is Ablation to Termination the Best Strategy for Ablation of Persistent Atrial Fibrillation?

Lim

Derval

Komatsu³

et al. 2015

Circ: Arrhythmia and Electrophysiology

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A lthough effective results are attained with paroxysmal atrial fibrillation (AF) ablation based on pulmonary vein isolation (PVI), catheter ablation of persistent AF remains a challenging task. Current ablation approaches in persistent AF ablation are markedly diverse, and there is a considerable variation in the reported clinical outcomes.1 Moreover, the lack of a distinct procedural end point makes comparison between the studies difficult. Response by Latchamsetty and Oral on p 971Recently, significant advances have been made with the development of novel technologies, such as computational mapping and panoramic noninvasive mapping to map drivers (rotors and focal discharges) during AF. The advent of these newer technologies and strategies for persistent AF ablation further raise the question as to whether AF termination should be the procedural end point, and whether it confers additional long-term clinical benefit.In this article, we review the current evidence on AF termination and long-term clinical outcome, procedural AF termination as a predictor of freedom from recurrent atrial arrhythmias, AF termination rates with various ablation strategies, and potential underlying mechanisms conferring clinical benefit and future directions. AF Termination and Clinical Outcome Search StrategyThe English scientific literature in the PubMed database was searched using the terms catheter ablation, persistent AF, and termination in any region of the PubMed record until October 2014. Studies that described procedural AF termination rates during ablation together with clinical outcomes after ablation for patients with persistent AF or long-standing persistent AF were included. References from the relevant articles were reviewed to identify further related articles. Definition of AF termination included direct conversion to sinus rhythm (SR) and organization to atrial tachycardia (AT) during ablation.

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“…Importantly, if the stepwise ablation strategy is used, termination of AF during the index procedure is predictive of arrhythmia-free outcome. [70][71][72]74,75 Gradual prolongation of AF cycle length during substrate ablation up to AF termination and the predictive value of AF termination for arrhythmia-free outcome both indicate that the atrial substrate plays an important role in AF perpetuation and that substrate modification by ablation is important. Patients in whom AF is terminated by ablation during the index procedure tend to have atrial tachycardias in case of arrhythmia recurrence, whereas patients in whom termination is not achieved mostly recur in form of AF.…”

Section: Stepwise Ablationmentioning

confidence: 99%

Catheter Ablation for Persistent Atrial Fibrillation

Roten

Derval

Jaı̈s

2012

Circ: Arrhythmia and Electrophysiology

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Termination of Long‐Lasting Persistent Versus Short‐Lasting Persistent and Paroxysmal Atrial Fibrillation by Ablation

Cited by 36 publications

References 43 publications

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Is Ablation to Termination the Best Strategy for Ablation of Persistent Atrial Fibrillation?

Catheter Ablation for Persistent Atrial Fibrillation

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