Background Atrial fibrillation (AF) drivers outside pulmonary veins (PV) may account for failure after PV isolation. The aim of this study was to characterize pre-existent areas of complex fractionated atrial electrograms (CFAEs) recorded in right atrium (RA) and in coronary sinus (CS) during catheter-based PV isolation and to assess their relation to outcome. Methods and results With a tricuspid annulus and CS mapping, CFAEs were retrospectively identified in consecutive patients who underwent PV isolation. Of 224 patients, 161 were found to have CFAEs (81%). No clinical variable was found to be predictive of CFAEs presence. By Kaplan-Meier analysis, following a median follow-up of 23.7 months after a single ablation procedure, 62.8% of patients in the CFAEs(+) group and 85.4% of those in the CFAEs(-) group were free from recurrent atrial tachyarrhythmias (p=0.013). Multivariable Cox regression analysis showed that CFAEs evidence was an independent predictor of recurrence (p=0.007). Conclusions Pre-existent CFAEs, that can be easily identified in RA and CS during PV isolation, are a powerful independent predictor for AF recurrence. This finding may be helpful for refining AF ablation strategies.

Forleo, G.b., Mantica, M., De Luca, L., Dello Russo, A., Casella, M., Santini, L., et al. (2008). Impact of pre-existent areas of complex fractionated atrial electrograms on outcome after pulmonary vein isolation. JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 21(3), 227-234 [10.1007/s10840-008-9240-3].

Impact of pre-existent areas of complex fractionated atrial electrograms on outcome after pulmonary vein isolation

ROMEO, FRANCESCO;
2008-01-01

Abstract

Background Atrial fibrillation (AF) drivers outside pulmonary veins (PV) may account for failure after PV isolation. The aim of this study was to characterize pre-existent areas of complex fractionated atrial electrograms (CFAEs) recorded in right atrium (RA) and in coronary sinus (CS) during catheter-based PV isolation and to assess their relation to outcome. Methods and results With a tricuspid annulus and CS mapping, CFAEs were retrospectively identified in consecutive patients who underwent PV isolation. Of 224 patients, 161 were found to have CFAEs (81%). No clinical variable was found to be predictive of CFAEs presence. By Kaplan-Meier analysis, following a median follow-up of 23.7 months after a single ablation procedure, 62.8% of patients in the CFAEs(+) group and 85.4% of those in the CFAEs(-) group were free from recurrent atrial tachyarrhythmias (p=0.013). Multivariable Cox regression analysis showed that CFAEs evidence was an independent predictor of recurrence (p=0.007). Conclusions Pre-existent CFAEs, that can be easily identified in RA and CS during PV isolation, are a powerful independent predictor for AF recurrence. This finding may be helpful for refining AF ablation strategies.
2008
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE
English
Atrial fibrillation; Catheter ablation; Fractionated electrograms
adult; article; catheter ablation; controlled study; coronary sinus; electrography; female; follow up; heart atrium fibrillation; heart catheterization; heart right atrium; human; Kaplan Meier method; major clinical study; male; multivariate analysis; priority journal; proportional hazards model; pulmonary vein; recurrent disease; retrospective study; statistical significance; tachycardia; treatment outcome; Atrial Fibrillation; Catheter Ablation; Coronary Sinus; Cross-Sectional Studies; Electrocardiography; Electrophysiologic Techniques, Cardiac; Female; Heart Atria; Humans; Male; Middle Aged; Proportional Hazards Models; Pulmonary Veins; Recurrence; Retrospective Studies; Treatment Outcome
Forleo, G.b., Mantica, M., De Luca, L., Dello Russo, A., Casella, M., Santini, L., et al. (2008). Impact of pre-existent areas of complex fractionated atrial electrograms on outcome after pulmonary vein isolation. JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 21(3), 227-234 [10.1007/s10840-008-9240-3].
Forleo, Gb; Mantica, M; De Luca, L; Dello Russo, A; Casella, M; Santini, L; Pelargonio, G; Romeo, F; Tondo, C
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/57776
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