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Electrogram-guided substrate ablation with or without pulmonary vein isolation in patients with persistent atrial fibrillation
Aims Ablation of complex fractionated atrial electrograms (CFAEs) is a new approach for the treatment of atrial fibrillation (AF). The purpose of the study was to assess the efficacy of CFAE ablation as a stand-alone strategy in patients with persistent AF and to compare it with a combined approach...
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Published in: | Europace (London, England) England), 2008-11, Vol.10 (11), p.1281-1287 |
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Main Authors: | , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Request full text |
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Summary: | Aims
Ablation of complex fractionated atrial electrograms (CFAEs) is a new approach for the treatment of atrial fibrillation (AF). The purpose of the study was to assess the efficacy of CFAE ablation as a stand-alone strategy in patients with persistent AF and to compare it with a combined approach of CFAE ablation and pulmonary vein isolation (PVI).
Methods and results
The study included 77 consecutive patients with persistent AF who underwent radiofrequency (RF) ablation of CFAE as a sole ablation procedure (CFAE group, n = 23 patients) or a combined approach of CFAE ablation and PVI (CFAE plus PVI group, n = 54 patients). Procedures were guided by three-dimensional mapping systems. After the procedure, AF recurrences were evaluated with 7-day Holter recordings at 1, 3, and 6 months and every 6 months thereafter. Treatment failure was defined as ≥1 AF episode lasting >30 s on Holter recordings during follow-up. After a mean follow-up time of 13 ± 10 months, 2 of 23 patients (9%) with CFAE ablation and 22 of 54 patients (41%) with CFAE plus PVI were in sinus rhythm after a single ablation procedure without anti-arrhythmic medication (P = 0.008).
Conclusion
Ablation of CFAE as a stand-alone ablation strategy seems insufficient for the treatment of patients with persistent AF. Pulmonary vein isolation plus CFAE ablation significantly increases the mid-term success rate. |
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ISSN: | 1099-5129 1532-2092 |
DOI: | 10.1093/europace/eun244 |