Comparison of clinical outcomes of Ibutilide-guided cardioversion and direct current synchronized cardioversion after radiofrequency ablation of persistent atrial fibrillation

Figures

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  Figure 1. Study design. AF, atrial fibrillation; AFL, atrial flutter; AT, atrial tachycardia; DCC, direct current synchronized cardioversion; LA, left atrial; LVZs, low voltage zones; PVI, pulmonary vein isolation; SCV, spontaneous conversion; SR, sinus rhythm.

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  Figure 2. LVZs-guided extra linear ablation. (A) LA posterior wall Box ablation if there were sufficient LVA in the LA posterior wall; (B) Mitral isthmus ablation if LA isthmus contained significant LVA; (C) Anterior linear ablation if LA anterior involved significant LVA. Bipolar voltage <0.5 mV represented the LVZs (non-purple) and bipolar voltage >0.5 mV represented the normal substrate (purple). LA, left atrial; LVZs, low voltage zones; LVA, low-voltage area.

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  Figure 3. Patients flow of the study. αAdditional ablation inclued AFL/AT ablation during the operation, clinical typical AFL ablation, or LVZs-guided extra ablation; βOne patient in DCC group died of traffic accident and was lost to follow-up. AF, atrial fibrillation; AFL, atrial flutter; AT, atrial tachycardia; DCC, direct current synchronized cardioversion; LA, left atrial; LVZs, low voltage zones; PVI, pulmonary vein isolation; SCV, spontaneous conversion; SR, sinus rhythm.

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  Figure 4. Kaplan–Meier analysis of freedom from atrial tachyarrhythmia among three different cardioversion. (A) Kaplan–Meier analysis of freedom from atrial tachyarrhythmia among SCV vs. DCC vs. Ibutilide groups at 12 months follow-up; (B) Kaplan–Meier analysis of freedom from atrial tachyarrhythmia among SCV vs. DCC vs. Ibutilide groups at median 17 months follow-up. DCC, direct current synchronized cardioversion; SCV, spontaneous conversion.

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  Figure 5. Kaplan–Meier analysis of freedom from atrial tachyarrhythmia in different Ibutilide subgroups. (A) Kaplan–Meier analysis of freedom from atrial tachyarrhythmia among Ibutilide conversion vs. AF/AFL vs. DCC subgroups at 12 months follow-up; (B) Kaplan–Meier analysis of freedom from atrial tachyarrhythmia among Ibutilide conversion vs. AF/AFL vs. DCC subgroups at median 17 months follow-up; (C) Kaplan–Meier analysis of freedom from atrial tachyarrhythmia in effective ibutilide vs. noneffective ibutilide subgroups at 12 months follow-up; (D) Kaplan–Meier analysis of freedom from atrial tachyarrhythmia in effective ibutilide vs. noneffective ibutilide subgroups at median 17 months follow-up. AFL, atrial flutter; AT, atrial tachycardia; DCC, direct current synchronized cardioversion.