Heart rhythm · 2010
Rapid pulmonary vein isolation combined with autonomic ganglia modification: a randomized study.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Katritsis Demosthenes G, Giazitzoglou Eleftherios, Zografos Theodoros, Pokushalov Evgeny, Po Sunny S, Camm A John
Аннотация
BACKGROUND: Evidence indicates that the combination of left atrial ganglionated plexi (GP) ablation and pulmonary vein (PV) isolation is beneficial for treatment of paroxysmal atrial fibrillation (AF).
OBJECTIVE: The purpose of this study was to compare GP and PV ablation with PV isolation alone for treatment of paroxysmal AF.
METHODS: Sixty-seven patients with paroxysmal AF were randomized to either PV isolation using a circular catheter suitable for both mapping and ablation (PV group) or anatomic GP modification followed by PV isolation (GP+PV group). Patients were seen at monthly visits, and 48-hour ambulatory ECG recordings were obtained every 3 months for a predefined follow-up period of 12 months. Primary endpoint was freedom from AF or other sustained atrial arrhythmia recurrence 3 to 12 months postablation after one or two procedures, without antiarrhythmic medications.
RESULTS: Recurrence of arrhythmia was documented in 18 (54.5%) patients in the PV group 4.7 ± 1.0 months after ablation, and repeat PV isolation was performed in 7 (21.2%) of these patients 5.1 ± 1.1 months after the first procedure. Recurrence of arrhythmia was documented in 9 (26.5%) patients in the GP+PV group 5.0 ± 1.3 months after ablation, and repeat ablation was performed in 6 (17.6%) of these patients 4.3 ± 0.5 months after the first procedure. At the end of follow-up, 20 (60.6%) patients in the PV group and 29 (85.3%) patients in the GP+PV group remained arrhythmia-free (log rank test, P = .019).
CONCLUSION: Addition of anatomic GP modification to PV isolation confers significantly better outcomes than PV isolation alone during a follow-up period of 12 months.
OBJECTIVE: The purpose of this study was to compare GP and PV ablation with PV isolation alone for treatment of paroxysmal AF.
METHODS: Sixty-seven patients with paroxysmal AF were randomized to either PV isolation using a circular catheter suitable for both mapping and ablation (PV group) or anatomic GP modification followed by PV isolation (GP+PV group). Patients were seen at monthly visits, and 48-hour ambulatory ECG recordings were obtained every 3 months for a predefined follow-up period of 12 months. Primary endpoint was freedom from AF or other sustained atrial arrhythmia recurrence 3 to 12 months postablation after one or two procedures, without antiarrhythmic medications.
RESULTS: Recurrence of arrhythmia was documented in 18 (54.5%) patients in the PV group 4.7 ± 1.0 months after ablation, and repeat PV isolation was performed in 7 (21.2%) of these patients 5.1 ± 1.1 months after the first procedure. Recurrence of arrhythmia was documented in 9 (26.5%) patients in the GP+PV group 5.0 ± 1.3 months after ablation, and repeat ablation was performed in 6 (17.6%) of these patients 4.3 ± 0.5 months after the first procedure. At the end of follow-up, 20 (60.6%) patients in the PV group and 29 (85.3%) patients in the GP+PV group remained arrhythmia-free (log rank test, P = .019).
CONCLUSION: Addition of anatomic GP modification to PV isolation confers significantly better outcomes than PV isolation alone during a follow-up period of 12 months.