Article: Randomized comparison between pulmonary vein antral isolation versus complex fractionated electrogram ablation for paroxysmal atrial fibrillation
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- Publisher Website: 10.1111/j.1540-8167.2011.02051.x
- Scopus: eid_2-s2.0-80052837251
- PMID: 21539635
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| Title | Randomized comparison between pulmonary vein antral isolation versus complex fractionated electrogram ablation for paroxysmal atrial fibrillation | ||||
|---|---|---|---|---|---|
| Authors | Chen, M3 Yang, B3 Chen, H3 Ju, W3 Zhang, F3 Tse, HF1 2 Cao, K3 | ||||
| Keywords | atrial fibrillation catheter ablation complex fractionated electrograms pulmonary veins | ||||
| Issue Date | 2011 | ||||
| Publisher | Wiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873 | ||||
| Citation | Journal Of Cardiovascular Electrophysiology, 2011, v. 22 n. 9, p. 973-981 [How to Cite?] DOI: http://dx.doi.org/10.1111/j.1540-8167.2011.02051.x | ||||
| Abstract | Catheter Ablation of Paroxysmal AF. Introduction: Circumferential pulmonary vein antral isolation (PVAI) and atrial complex fractionated electrograms (CFEs) are both ablative techniques for the treatment of paroxysmal atrial fibrillation (PAF). However, data on the comparative value of these 2 ablation strategies are very limited. Methods and Results: We randomized 118 patients with drug-refractory PAF to receive PVAI ablation (n = 60) or CFE ablation (n = 58). For CFE group, spontaneous/induced AF was mapped using validated, automated software to guide ablation until all CFE areas were eliminated. For PVAI group, all 4 pulmonary vein antra were electrically isolated as confirmed by circular mapping catheter. Patients with spontaneous/inducible AF after the initial ablation procedure were crossed over to the other arms. After initial ablation procedure, AF persisted/inducible in 24/59 patients (41%), and 34/58 patients (59%) assigned to PVAI and CFE ablation, respectively (P = 0.05). Then 58 patients underwent PVAI + CFE ablation. After 22.6 ± 6.4 months, PVAI ablation group was more likely than CFE ablation group to achieve control of any AF/atrial tachycardia (AT) off drugs (43/60, 72% vs 33/58, 57%, P = 0.075) and lower recurrence rate of AT (11.9% vs 34.5%, P = 0.004). Patients who received CFE ablation alone (38%) had significantly lower overall success rate to achieve control of AF/AT off drugs compared with patients who received PVAI ablation (77%, P = 0.002) alone or PVAI + CFE ablation (69%, P = 0.008) due to higher recurrence rate of AT (50% vs 6% vs 13%, P < 0.01). Conclusions: CFE ablation in PAF patients was associated with higher occurrence rate of postprocedure AT compared with PVAI ablation, whereby making it less likely to be a sole ablation strategy for PAF patients. © 2011 Wiley Periodicals, Inc. | ||||
| ISSN | 1045-3873 2011 Impact Factor: 3.064 2011 SCImago Journal Rankings: 0.334 | ||||
| DOI | http://dx.doi.org/10.1111/j.1540-8167.2011.02051.x | ||||
| ISI Accession Number ID | WOS:000295131200004
Funding Information: This work was supported by a grant from Provincial Natural Science of Jiangsu Province, China (BK2005218). | ||||
| References | References in Scopus |
| dc.contributor.author | Chen, M | ||||
|---|---|---|---|---|---|
| dc.contributor.author | Yang, B | ||||
| dc.contributor.author | Chen, H | ||||
| dc.contributor.author | Ju, W | ||||
| dc.contributor.author | Zhang, F | ||||
| dc.contributor.author | Tse, HF | ||||
| dc.contributor.author | Cao, K | ||||
| dc.date.accessioned | 2011-07-27T01:30:21Z | ||||
| dc.date.available | 2011-07-27T01:30:21Z | ||||
| dc.date.issued | 2011 | ||||
| dc.description.abstract | Catheter Ablation of Paroxysmal AF. Introduction: Circumferential pulmonary vein antral isolation (PVAI) and atrial complex fractionated electrograms (CFEs) are both ablative techniques for the treatment of paroxysmal atrial fibrillation (PAF). However, data on the comparative value of these 2 ablation strategies are very limited. Methods and Results: We randomized 118 patients with drug-refractory PAF to receive PVAI ablation (n = 60) or CFE ablation (n = 58). For CFE group, spontaneous/induced AF was mapped using validated, automated software to guide ablation until all CFE areas were eliminated. For PVAI group, all 4 pulmonary vein antra were electrically isolated as confirmed by circular mapping catheter. Patients with spontaneous/inducible AF after the initial ablation procedure were crossed over to the other arms. After initial ablation procedure, AF persisted/inducible in 24/59 patients (41%), and 34/58 patients (59%) assigned to PVAI and CFE ablation, respectively (P = 0.05). Then 58 patients underwent PVAI + CFE ablation. After 22.6 ± 6.4 months, PVAI ablation group was more likely than CFE ablation group to achieve control of any AF/atrial tachycardia (AT) off drugs (43/60, 72% vs 33/58, 57%, P = 0.075) and lower recurrence rate of AT (11.9% vs 34.5%, P = 0.004). Patients who received CFE ablation alone (38%) had significantly lower overall success rate to achieve control of AF/AT off drugs compared with patients who received PVAI ablation (77%, P = 0.002) alone or PVAI + CFE ablation (69%, P = 0.008) due to higher recurrence rate of AT (50% vs 6% vs 13%, P < 0.01). Conclusions: CFE ablation in PAF patients was associated with higher occurrence rate of postprocedure AT compared with PVAI ablation, whereby making it less likely to be a sole ablation strategy for PAF patients. © 2011 Wiley Periodicals, Inc. | ||||
| dc.description.nature | Link_to_subscribed_fulltext | ||||
| dc.identifier.citation | Journal Of Cardiovascular Electrophysiology, 2011, v. 22 n. 9, p. 973-981 [How to Cite?] DOI: http://dx.doi.org/10.1111/j.1540-8167.2011.02051.x | ||||
| dc.identifier.doi | http://dx.doi.org/10.1111/j.1540-8167.2011.02051.x | ||||
| dc.identifier.epage | 981 | ||||
| dc.identifier.hkuros | 187308 | ||||
| dc.identifier.isi | WOS:000295131200004
Funding Information: This work was supported by a grant from Provincial Natural Science of Jiangsu Province, China (BK2005218). | ||||
| dc.identifier.issn | 1045-3873 2011 Impact Factor: 3.064 2011 SCImago Journal Rankings: 0.334 | ||||
| dc.identifier.issue | 9 | ||||
| dc.identifier.openurl | | ||||
| dc.identifier.pmid | 21539635 | ||||
| dc.identifier.scopus | eid_2-s2.0-80052837251 | ||||
| dc.identifier.spage | 973 | ||||
| dc.identifier.uri | http://hdl.handle.net/10722/135230 | ||||
| dc.identifier.volume | 22 | ||||
| dc.language | eng | ||||
| dc.publisher | Wiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873 | ||||
| dc.publisher.place | United States | ||||
| dc.relation.ispartof | Journal of Cardiovascular Electrophysiology | ||||
| dc.relation.references | References in Scopus | ||||
| dc.rights | The definitive version is available at www3.interscience.wiley.com | ||||
| dc.subject | atrial fibrillation | ||||
| dc.subject | catheter ablation | ||||
| dc.subject | complex fractionated electrograms | ||||
| dc.subject | pulmonary veins | ||||
| dc.title | Randomized comparison between pulmonary vein antral isolation versus complex fractionated electrogram ablation for paroxysmal atrial fibrillation | ||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong Li Ka Shing Faculty of Medicine
- The University of Hong Kong
- Nanjing Medical University