Impact of residual induction number of non-pulmonary vein foci on the 2-year outcomes in patients with paroxysmal atrial fibrillation.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-10-01 Epub Date: 2024-05-04 DOI:10.1007/s10840-024-01820-z

Yasuyuki Egami, Masaru Abe, Mizuki Osuga, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino

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引用次数: 0

Abstract

Background: Residual non-pulmonary vein (PV) foci are significantly associated with atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). However, we previously reported among patients with non-PV foci induced only once, none experienced AF recurrence. Thus, we aimed to investigate the correlation between the residual induction number of non-PV foci and ablation outcome in paroxysmal AF patients.

Methods and results: We investigated 55 paroxysmal AF patients with residual non-PV foci after PVI and ablation of non-PV-foci. Study patients were classified into the residual one-time induction of non-PV foci (residual OTI-nPVF) group (n = 23) and residual repeatedly induced non-PV foci (residual RI-nPVF) group (n = 32). Furthermore, the residual RI-nPVF group was divided into the low inducibility group (n = 10) and high inducibility group (n = 22) according to the presence or absence of non-PV foci provoked by two sets of drug induction tests (non-PV foci inducibility). In addition, the latter was divided into the ablation group (n = 14) or observation group (n = 8). The 2-year AF recurrence-free rate in the residual RI-nPVF group was significantly lower compared to the residual OTI-nPVF group (53% vs. 90%, p = 0.018). There was no significant difference of the 2-year AF recurrence-free rates in the inducibility of non-PV foci (p = 0.913) and the presence or absence of ablation (p = 0.812) in the residual RI-nPVF group.

Conclusions: Among paroxysmal AF patients, the presence of residual RI-nPVF was associated with higher AF recurrence compared to residual OTI-nPVF. Furthermore, within residual RI-nPVF subgroup, non-PV foci inducibility or ablation of some residual RI-nPVF did not affect ablation outcome.

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非肺静脉病灶残留诱导数对阵发性心房颤动患者两年预后的影响

背景：肺静脉隔离术（PVI）后，残留的非肺静脉（PV）病灶与房颤（AF）复发密切相关。然而，我们以前曾报告过，在仅诱发过一次非 PV 病灶的患者中，没有人出现房颤复发。因此，我们旨在研究非 PV 病灶的剩余诱导次数与阵发性房颤患者消融结果之间的相关性：我们对 55 名阵发性房颤患者进行了调查，这些患者在 PVI 和非 PV 病灶消融术后有残留的非 PV 病灶。研究患者被分为残留一次性诱导非 PV 病灶（残留 OTI-nPVF）组（23 人）和残留反复诱导非 PV 病灶（残留 RI-nPVF）组（32 人）。此外，残留 RI-nPVF 组根据两组药物诱导试验（非 PV 病灶诱导性）所诱发的非 PV 病灶的有无分为低诱导性组（n = 10）和高诱导性组（n = 22）。此外，后者还被分为消融组（n = 14）或观察组（n = 8）。残留 RI-nPVF 组的 2 年无房颤复发率明显低于残留 OTI-nPVF 组（53% 对 90%，P = 0.018）。残留RI-nPVF组的2年无房颤复发率在非PV灶的可诱导性（p = 0.913）和有无消融（p = 0.812）方面无明显差异：在阵发性房颤患者中，与残留的 OTI-nPVF 相比，残留的 RI-nPVF 与更高的房颤复发率相关。此外，在残留 RI-nPVF 亚组别中，非 PV 病灶诱导或消融部分残留 RI-nPVF 不会影响消融结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.