Prognostic role of subsequent atrial tachycardias occurring during ablation of persistent atrial fibrillation: a prospective randomized trial

Rostock, Thomas; Salukhe, Tushar V; Hoffmann, Boris A; Steven, Daniel; Berner, Imke; Müllerleile, Kai; Theis, Cathrin; Bock, Karsten; Servatius, Helge; Sultan, Arian; Willems, Stephan (2013). Prognostic role of subsequent atrial tachycardias occurring during ablation of persistent atrial fibrillation: a prospective randomized trial. Circulation. Arrhythmia and electrophysiology, 6(6), pp. 1059-1065. Lippincott Williams & Wilkins 10.1161/CIRCEP.113.001019

Full text not available from this repository.

BACKGROUND

The role of subsequent atrial tachycardias (AT) in the context of persistent atrial fibrillation (AF) remains undetermined. This study evaluated the prognostic role of subsequent ATs for arrhythmia recurrences after catheter ablation of persistent AF.

METHODS AND RESULTS

A total of 110 patients with persistent AF (63±9 years; 22 women; 61 long-lasting persistent AF) underwent pulmonary vein isolation followed by electrogram-guided ablation. After AF terminated to AT, patients were separated by the randomization protocol to receive either direct cardioversion (group A) or further ablation of subsequent ATs to sinus rhythm (group B). After a mean follow-up of 20.1±13.3 months after the first procedure, significantly more group B patients were in sinus rhythm as compared with patients in group A (30 [57%] versus 18 [34%]; P=0.02). Moreover, recurrences of AF were significantly less frequent of group B than in group A patients (10 [19%] versus 26 [49%]; P=0.001). After the last procedure (follow-up, 34.0±6.4 months), significantly more group B patients were free of AF as compared with patients of group A (49 [92%] versus 39 [74%]; P=0.01). The proportion of AT recurrences did not differ between the 2 groups after the first and final procedures. The strongest predictor for an arrhythmia-free survival after a single procedure was randomization to the procedural end point of termination to sinus rhythm by elimination of subsequent ATs (P=0.004).

CONCLUSIONS

Catheter ablation of subsequent ATs increases freedom from AF but not AT, suggesting a contributing role of subsequent ATs in the mechanisms of persistent AF.

CLINICAL TRIAL REGISTRATION

URL: http://www.clinicaltrials.gov. Unique identifier: NCT01896570.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Servatius, Helge Simon (A)
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1941-3084
Publisher:	Lippincott Williams & Wilkins
Language:	English
Submitter:	Helge Simon Servatius
Date Deposited:	03 Mar 2014 09:58
Last Modified:	29 Mar 2023 23:33
Publisher DOI:	10.1161/CIRCEP.113.001019
PubMed ID:	24162833
Uncontrolled Keywords:	arrhythmias cardiac, atrial fibrillation, catheter ablation, tachycardia, ectopic atrial
URI:	https://boris.unibe.ch/id/eprint/42344