What question did this study set out to answer?

This research aims to evaluate the necessity of left atrial linear lesions for terminating persistent atrial fibrillation and preventing macro re-entrant atrial tachycardia.

July 8, 2008European Heart JournalOpen Access

Left atrial linear lesions are required for successful treatment of persistent atrial fibrillation

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Why the study?

Does catheter ablation without left atrial linear lesions increase the incidence of macro re-entrant atrial tachycardia compared to ablation with linear lesions in patients with persistent atrial fibrillation?

Population

154 patients with persistent atrial fibrillation terminated by catheter ablation, with an AF history of 60…

Comparison

Catheter ablation without the need for both left… vs Catheter ablation requiring both left atrial…

Design

Cohort

Follow-up

28 months

Authors

SKSébastien KnechtElectrophysiology MHMélèze HociniUniversité de Bordeaux MWMatthew WrightElectrophysiology

Discussion

Member takes

Implication

May increase macro re-entrant AT risk after persistent AF ablation without linear lesions; leaves open whether routine use improves outcomes in randomized trials.

Key Points

This research aims to evaluate the necessity of left atrial linear lesions for terminating persistent atrial fibrillation and preventing macro re-entrant atrial tachycardia.
Evaluated 180 consecutive patients with persistent atrial fibrillation undergoing catheter ablation.
Patients divided into two groups based on the need for left atrial linear lesions to terminate atrial fibrillation.
Incidence of macro re-entrant atrial tachycardia monitored over 28 months of follow-up.
Incidence of macro re-entrant atrial tachycardia was 76% in group A (no linear lesions) vs. 33% in group B (with linear lesions), P=0.002.
Patients in group A had a shorter duration of continuous AF (9 months vs. 12 months in group B), P=0.03.
Higher incidence of subsequent atrial tachycardia when complete linear block was not achieved (roof P=0.008, mitral isthmus P=0.010).

Structured PICO

Population

154 patients with persistent atrial fibrillation terminated by catheter ablation (out of 180 consecutive patients), with an AF history of 60 months including 11 months of continuous AF.

Intervention

Catheter ablation without the need for both left atrial linear lesions (roof and mitral lines) to terminate AF

Comparator

Catheter ablation requiring both left atrial linear lesions to terminate AF

Outcome

Incidence of left atrial macro re-entrant atrial tachycardia (AT) necessitating linear ablation at 28 months follow-uphard clinical

In patients with persistent atrial fibrillation, omitting left atrial linear lesions during catheter ablation results in a high rate of subsequent macro re-entrant atrial tachycardia requiring further ablation.

Cite This Study

Knecht et al. (2008) studied this question.

synapsesocial.com/papers/69fa89daaa3ec536f251219a https://doi.org/10.1093/eurheartj/ehn302

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

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Implication

May increase macro re-entrant AT risk after persistent AF ablation without linear lesions; leaves open whether routine use improves outcomes in randomized trials.

Left atrial linear lesions are required for successful treatment of persistent atrial fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Left atrial linear lesions are required for successful treatment of persistent atrial fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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