Impact of Prolonged Cycle Length Resulting From Conversion of Atrial Fibrillation to Atrial Tachycardia on Ablation Outcome in Persistent Atrial Fibrillation Ablation

IF 3.4 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Jialing He, Guoshu Yang, Duan Luo, Yongxin Yang, Guijun He, Xianchen Yang, Zhen Zhang
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引用次数: 0

Abstract

Background: There is limited available data regarding the impact of cycle length (CL) prolongation when converting atrial fibrillation (AF) to organized atrial tachycardia (AT) and its effect on clinical outcomes.

Methods and Method: We retrospectively screened and included a cohort of 132 patients with persistent or long-standing persistent AF who underwent circumferential pulmonary vein isolation (CPVI) and left atrial substrate modification (LASM) between January 2015 and October 2019. In all 132 consecutive patients, persistent AF was successfully converted into organized AT. For cases with recurrence after a 3-month blanking period, a repeat procedure was conducted.

Results: We observed a notable prolongation in CL after ablation (average increase of 56.6 ± 30 ms). Following a median follow-up duration of 9.5 ± 5.1 months, 27 patients experienced recurrence. Through receiver operating curve (ROC) analysis, a prolonged CL cut-off of 42.5 ms was identified, with a specificity of 71% and a sensitivity of 59.4%. Patients were categorized into two groups: those with CL less than 42.5 ms (group A, n = 48) and those with CL more than 42.5 ms (group B, n = 84). The Kaplan–Meier survival curves demonstrated a significantly higher recurrence-free rate after catheter ablation in group B compared to group A (p = 0.002).

Conclusions: Upon termination of persistent AF into AT during ablation, it was found that CL prolongation beyond 42.5 ms was associated with improved freedom from arrhythmia.

Abstract Image

心房颤动转化为房性心动过速导致的周期长度延长对持续性心房颤动消融术消融结果的影响
背景:关于心房颤动(AF)转化为有组织性房性心动过速(AT)时周期长度(CL)延长的影响及其对临床结果的影响,现有数据有限:我们回顾性筛选并纳入了2015年1月至2019年10月期间接受环行肺静脉隔离术(CPVI)和左心房基底改造术(LASM)的132例持续性或长期持续性房颤患者。在所有 132 名连续患者中,持续性房颤均成功转化为有组织 AT。对于 3 个月空白期后复发的病例,进行了重复手术:我们观察到消融术后CL明显延长(平均增加56.6 ± 30 ms)。中位随访时间为 9.5 ± 5.1 个月,27 名患者复发。通过接收器操作曲线(ROC)分析,确定了 42.5 毫秒的 CL 延长临界值,其特异性为 71%,灵敏度为 59.4%。患者被分为两组:CL 小于 42.5 毫秒的患者(A 组,n = 48)和 CL 大于 42.5 毫秒的患者(B 组,n = 84)。Kaplan-Meier生存曲线显示,与A组相比,B组患者导管消融后的无复发率明显更高(P = 0.002):结论:在消融过程中将持续性房颤终止为 AT 时,发现 CL 延长至 42.5 毫秒以上与改善心律失常无复发率有关。
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来源期刊
Cardiovascular Therapeutics
Cardiovascular Therapeutics 医学-心血管系统
CiteScore
5.60
自引率
0.00%
发文量
55
审稿时长
6 months
期刊介绍: Cardiovascular Therapeutics (formerly Cardiovascular Drug Reviews) is a peer-reviewed, Open Access journal that publishes original research and review articles focusing on cardiovascular and clinical pharmacology, as well as clinical trials of new cardiovascular therapies. Articles on translational research, pharmacogenomics and personalized medicine, device, gene and cell therapies, and pharmacoepidemiology are also encouraged. Subject areas include (but are by no means limited to): Acute coronary syndrome Arrhythmias Atherosclerosis Basic cardiac electrophysiology Cardiac catheterization Cardiac remodeling Coagulation and thrombosis Diabetic cardiovascular disease Heart failure (systolic HF, HFrEF, diastolic HF, HFpEF) Hyperlipidemia Hypertension Ischemic heart disease Vascular biology Ventricular assist devices Molecular cardio-biology Myocardial regeneration Lipoprotein metabolism Radial artery access Percutaneous coronary intervention Transcatheter aortic and mitral valve replacement.
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