单位:[1]Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Belishi Rd #167, Xicheng District, Beijing 100037, China[2]Department of Cardiology, Beijing Anzhen Hospital Afliated To Capital Medical University, Beijing, China首都医科大学附属安贞医院[3]Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
Purpose We aimed to investigate whether the sequence of wide circumferential pulmonary vein isolation (PVI) ablation had an effect on the acute reconnection or long-term effectiveness in patients with paroxysmal atrial fibrillation (AF). Methods One hundred consecutive paroxysmal AF patients, who were scheduled to accept PVI, were enrolled and randomized into two groups: (1) optimized group. Lesions were first applied to the anterior/posterior carina and the ridge between the left atrial (LA) appendage and the left pulmonary vein (PV). Then both circles were closed with continuous lesions. (2) Sequential group-continuous circular lesions were created counter-clockwise and started from the site of 6 o'clock. The primary endpoint was the freedom from non-blanking period recurrence of any atrial tachyarrhythmias lasting for 30 s or longer during the 1-year follow-up period after a single procedure. The secondary endpoint included safety endpoints, LA dwelling time, and fluoroscopy time/dose. Results Forty-nine patients in the optimized group and 48 patients in the sequential group were available for analysis. There was no difference between the AF-free rate of the optimized group and the sequential group (75.5% vs. 72.9%, p = 0.7715). Cox regression analysis found that acute reconnection had the potential to predict long-term recurrence at 1 year (Risk ratio 2.175, p = 0.0818). Both groups had similar safety endpoints, LA dwelling time, and fluoroscopy time/dose. Conclusions Adjusting the ablation sequence of PVI by ablating the anterior/posterior carina and the ridge between the left PV and the LA appendage first did not improve 1-year AF-free rate for paroxysmal AF.
第一作者单位:[1]Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Belishi Rd #167, Xicheng District, Beijing 100037, China
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推荐引用方式(GB/T 7714):
Guo Xiao-Gang,Ma Jian,Tang Qing-Hui,et al.Sequential versus optimized pulmonary vein isolation for paroxysmal atrial fibrillation: a pilot study[J].JOURNAL of INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY.2021,doi:10.1007/s10840-021-01082-z.
APA:
Guo Xiao-Gang,Ma Jian,Tang Qing-Hui,Liu Xu,Luo Bin...&Zhang Shu.(2021).Sequential versus optimized pulmonary vein isolation for paroxysmal atrial fibrillation: a pilot study.JOURNAL of INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY,,
MLA:
Guo Xiao-Gang,et al."Sequential versus optimized pulmonary vein isolation for paroxysmal atrial fibrillation: a pilot study".JOURNAL of INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY .(2021)