{"title":"房颤消融后腺苷性房颤的长期预后:倾向评分匹配分析。","authors":"Masayuki Ishimura, Masashi Yamamoto, Toshiharu Himi, Yoshio Kobayashi","doi":"10.1111/pace.14557","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nonpulmonary vein (non-PV) foci, in addition to pulmonary vein (PV), are considered important in initiating atrial fibrillation (AF).</p><p><strong>Objective: </strong>This study investigates the adenosine triphosphate (ATP) as a method for inducing non-PV ectopy.</p><p><strong>Methods: </strong>The study cohort consisted of 1388 patients with AF (728 with paroxysmal AF, 650 with nonparoxysmal AF) who underwent catheter ablation. To confirm dormant PV conductions and non-PV foci, 20 or 40 mg ATP was administered intravenously at the end of the procedure.</p><p><strong>Results: </strong>The ATP test induced AF in 36 of 1388 (2.6%) patients, in whom two (6%) had ectopy arising from the both atria, 15 (42%) from the right atrium (RA), and five (14%) from left atrium (LA). Because of a lack of reproducibility, the accurate location of non-PV foci was unidentified in the remaining 11 (31%) patients. Additional radiofrequency ablation to non-PV foci induced ATP administration was not performed in 34 patients. Among all 1388 patients, 64 were assigned to the ATP-AF(+) and ATP-AF(-) groups using a propensity score matching analysis (32 patients in each group). During the follow-up period, recurrent AF was observed in 9 of 32 (28%) patients in the ATP-AF(+) group and in 10 of 32 (31%) patients in the ATP-AF(-) group (log-rank p = .84, hazard ratio 0.91 [95% confidence interval 0.36-2.27]). In the univariate analysis, AF induction by ATP test was not predictive of AF recurrence (p = .78).</p><p><strong>Conclusion: </strong>ATP-induced AF was not associated with AF recurrence in the distant period.</p>","PeriodicalId":520740,"journal":{"name":"Pacing and clinical electrophysiology : PACE","volume":" ","pages":"1172-1179"},"PeriodicalIF":1.3000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Long-term outcome of adenosine-induced atrial fibrillation after atrial fibrillation ablation: A propensity score matching analysis.\",\"authors\":\"Masayuki Ishimura, Masashi Yamamoto, Toshiharu Himi, Yoshio Kobayashi\",\"doi\":\"10.1111/pace.14557\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Nonpulmonary vein (non-PV) foci, in addition to pulmonary vein (PV), are considered important in initiating atrial fibrillation (AF).</p><p><strong>Objective: </strong>This study investigates the adenosine triphosphate (ATP) as a method for inducing non-PV ectopy.</p><p><strong>Methods: </strong>The study cohort consisted of 1388 patients with AF (728 with paroxysmal AF, 650 with nonparoxysmal AF) who underwent catheter ablation. To confirm dormant PV conductions and non-PV foci, 20 or 40 mg ATP was administered intravenously at the end of the procedure.</p><p><strong>Results: </strong>The ATP test induced AF in 36 of 1388 (2.6%) patients, in whom two (6%) had ectopy arising from the both atria, 15 (42%) from the right atrium (RA), and five (14%) from left atrium (LA). Because of a lack of reproducibility, the accurate location of non-PV foci was unidentified in the remaining 11 (31%) patients. Additional radiofrequency ablation to non-PV foci induced ATP administration was not performed in 34 patients. Among all 1388 patients, 64 were assigned to the ATP-AF(+) and ATP-AF(-) groups using a propensity score matching analysis (32 patients in each group). During the follow-up period, recurrent AF was observed in 9 of 32 (28%) patients in the ATP-AF(+) group and in 10 of 32 (31%) patients in the ATP-AF(-) group (log-rank p = .84, hazard ratio 0.91 [95% confidence interval 0.36-2.27]). In the univariate analysis, AF induction by ATP test was not predictive of AF recurrence (p = .78).</p><p><strong>Conclusion: </strong>ATP-induced AF was not associated with AF recurrence in the distant period.</p>\",\"PeriodicalId\":520740,\"journal\":{\"name\":\"Pacing and clinical electrophysiology : PACE\",\"volume\":\" \",\"pages\":\"1172-1179\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2022-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pacing and clinical electrophysiology : PACE\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1111/pace.14557\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/7/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pacing and clinical electrophysiology : PACE","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.14557","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/12 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
背景:除肺静脉(PV)外,非肺静脉(non-PV)病灶被认为是诱发心房颤动(AF)的重要因素。目的:探讨三磷酸腺苷(ATP)诱导非pv异位的方法。方法:研究队列包括1388例房颤患者(728例为阵发性房颤,650例为非阵发性房颤),均行导管消融。为了确认休眠PV传导和非PV病灶,在手术结束时静脉注射20或40 mg ATP。结果:1388例患者中有36例(2.6%)采用ATP试验诱发房颤,其中2例(6%)为双心房异位,15例(42%)为右心房异位,5例(14%)为左心房异位。由于缺乏可重复性,其余11例(31%)患者未确定非pv病灶的准确位置。在34例患者中,没有对非pv灶诱导的ATP给予额外的射频消融。在所有1388例患者中,使用倾向评分匹配分析将64例患者分配到ATP-AF(+)组和ATP-AF(-)组(每组32例)。随访期间,ATP-AF(+)组32例患者中有9例(28%)发生房颤复发,ATP-AF(-)组32例患者中有10例(31%)发生房颤复发(log-rank p = 0.84,风险比0.91[95%可信区间0.36-2.27])。在单因素分析中,ATP试验诱导AF不能预测AF复发(p = 0.78)。结论:atp诱导的AF与AF远期复发无相关性。
Long-term outcome of adenosine-induced atrial fibrillation after atrial fibrillation ablation: A propensity score matching analysis.
Background: Nonpulmonary vein (non-PV) foci, in addition to pulmonary vein (PV), are considered important in initiating atrial fibrillation (AF).
Objective: This study investigates the adenosine triphosphate (ATP) as a method for inducing non-PV ectopy.
Methods: The study cohort consisted of 1388 patients with AF (728 with paroxysmal AF, 650 with nonparoxysmal AF) who underwent catheter ablation. To confirm dormant PV conductions and non-PV foci, 20 or 40 mg ATP was administered intravenously at the end of the procedure.
Results: The ATP test induced AF in 36 of 1388 (2.6%) patients, in whom two (6%) had ectopy arising from the both atria, 15 (42%) from the right atrium (RA), and five (14%) from left atrium (LA). Because of a lack of reproducibility, the accurate location of non-PV foci was unidentified in the remaining 11 (31%) patients. Additional radiofrequency ablation to non-PV foci induced ATP administration was not performed in 34 patients. Among all 1388 patients, 64 were assigned to the ATP-AF(+) and ATP-AF(-) groups using a propensity score matching analysis (32 patients in each group). During the follow-up period, recurrent AF was observed in 9 of 32 (28%) patients in the ATP-AF(+) group and in 10 of 32 (31%) patients in the ATP-AF(-) group (log-rank p = .84, hazard ratio 0.91 [95% confidence interval 0.36-2.27]). In the univariate analysis, AF induction by ATP test was not predictive of AF recurrence (p = .78).
Conclusion: ATP-induced AF was not associated with AF recurrence in the distant period.