Journal of cardiovascular electrophysiology · 2025
Isoproterenol for Unmasking Dormant Conduction and Non-Pulmonary Vein Triggers During Atrial Fibrillation Ablation: Prospective Multicenter Study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Oza Saumil R, Hincapie Daniela, Gupta Manasvi, Varley Allyson L, Thorne Christopher, Silverstein Joshua R, Gabr Mohamed, Thosani Amit J, Miranda-Arboleda Andres F, Osorio Jose, Velasco Alejandro, Jazayeri Mohammad-Ali, Sackett Matthew C, Costea Alexandru, Moretta Anthony, Kuk Richard, Silva Jose M, D'Souza Benjamin, Belden William, Metzl Mark D, Quin Matthew, Morris Kent E, Romero Jorge E, Steiger Nathaniel A, Sauer William, Zei Paul C
Аннотация
BACKGROUND: Pulmonary vein (PV) reconnection and the onset of non-PV triggers are frequently the cause of atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA). The effectiveness of using isoproterenol for unmasking dormant conduction and non-PV-triggers during AF RFCA and its effect on improving procedural and clinical outcomes is still controversial.
OBJECTIVE: To evaluate the effectiveness of isoproterenol for unmasking dormant conduction and non-PV triggers during RFCA for paroxysmal AF (PAF) and its effects on procedural and long-term clinical outcomes.
METHODS: In this prospective multicenter cohort from the REAL-AF registry, patients who underwent RFCA for PAF with and without isoproterenol administration from January 2018 to May 2023 were included. The primary efficacy outcome was freedom from all-atrial arrhythmia at 12-month follow-up. Secondary outcomes included procedural and long-term clinical outcomes, and procedure-related complications.
RESULTS: A total of 1102 patients were included (isoproterenol = 325 vs. control = 777) (mean age 66.73 ± 10.19 years; 53.05% male). There were no differences in baseline characteristics between the groups. Dormant conduction/non-PV triggers with isoproterenol were observed in 10.2% of the patients. Isoproterenol administration was associated with increased procedural times (109 (83-137.5) vs. 96 (74-122), p = 0.002), and decreased rates of first-pass PV isolation (74.84% vs. 80.14%, p = 0.007). There were no differences in freedom from all-atrial arrhythmias (HR 0.87, 95% CI [0.61-1.24], p = 0.4) or long-term clinical outcomes at 12 months of follow-up between the groups.
CONCLUSION: In patients undergoing RFCA for PAF, the use of isoproterenol was associated with increased procedural times and more extensive ablation, without improved clinical outcomes at 12-month follow-up.
OBJECTIVE: To evaluate the effectiveness of isoproterenol for unmasking dormant conduction and non-PV triggers during RFCA for paroxysmal AF (PAF) and its effects on procedural and long-term clinical outcomes.
METHODS: In this prospective multicenter cohort from the REAL-AF registry, patients who underwent RFCA for PAF with and without isoproterenol administration from January 2018 to May 2023 were included. The primary efficacy outcome was freedom from all-atrial arrhythmia at 12-month follow-up. Secondary outcomes included procedural and long-term clinical outcomes, and procedure-related complications.
RESULTS: A total of 1102 patients were included (isoproterenol = 325 vs. control = 777) (mean age 66.73 ± 10.19 years; 53.05% male). There were no differences in baseline characteristics between the groups. Dormant conduction/non-PV triggers with isoproterenol were observed in 10.2% of the patients. Isoproterenol administration was associated with increased procedural times (109 (83-137.5) vs. 96 (74-122), p = 0.002), and decreased rates of first-pass PV isolation (74.84% vs. 80.14%, p = 0.007). There were no differences in freedom from all-atrial arrhythmias (HR 0.87, 95% CI [0.61-1.24], p = 0.4) or long-term clinical outcomes at 12 months of follow-up between the groups.
CONCLUSION: In patients undergoing RFCA for PAF, the use of isoproterenol was associated with increased procedural times and more extensive ablation, without improved clinical outcomes at 12-month follow-up.