What question did this study set out to answer?

To evaluate the long-term clinical efficacy, safety, and predictors of arrhythmia recurrence following pulmonary vein isolation with a ring-shaped multielectrode ablation catheter in patients with atrial fibrillation.

February 11, 2018Journal of Cardiovascular Medicine

Long-term outcomes and predictors of recurrence after pulmonary vein isolation with multielectrode ablation catheter in patients with atrial fibrillation

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Paroxysmal or persistent atrial fibrillation (n=125). Intervention: Pulmonary vein isolation with ring-shaped ablation catheter (PVAC) in paroxysmal AF vs. PVAC in persistent AF. Primary outcome: Freedom from any recurrence at 72 months (HR 2.76, p=0.001).

View Full Paper

Ask AI

Bookmark

Key result

PVAC effectively treats paroxysmal AF, while persistent AF is linked to ~176% greater recurrence risk.

HR 2.76
P=0.001
n=125

Why the study?

Does pulmonary vein isolation with a ring-shaped ablation catheter (PVAC) prevent recurrence of atrial arrhythmias in patients with paroxysmal or persistent atrial fibrillation?

Population

125 consecutive patients presenting with paroxysmal (78%) or persistent atrial fibrillation

Design

Cohort

Follow-up

mean 51 ± 14 months

Authors

SFSabine FredersdorfUniversity Hospital Regensburg CFCarolin FenzlUniversity Hospital Regensburg CJCarsten JungbauerElectrophysiology

Discussion

Member takes

Implication

May support PVAC in paroxysmal AF; leaves open efficacy in persistent AF pending randomized confirmation.

Key Points

To evaluate the long-term clinical efficacy, safety, and predictors of arrhythmia recurrence following pulmonary vein isolation with a ring-shaped multielectrode ablation catheter in patients with atrial fibrillation.
Consecutive patients presenting with paroxysmal atrial fibrillation (pxAF) or persistent atrial fibrillation (perAF) underwent ablation using a first-generation pulmonary vein ablation catheter (N=125; 78% pxAF).
Patients underwent standard 12-month clinical follow-up and extended long-term evaluation at a mean follow-up of 51 ± 14 months, which included medical history review and 3-day Holter monitoring.
Pulmonary vein isolation was successfully achieved in 99.6% (483 of 485) of veins; symptom-free rates at 12 months were 83% for pxAF and 53% for perAF, with 72-month recurrence-free rates reaching 56% for pxAF and 28% for perAF.
Independent predictors of arrhythmia recurrence were persistent atrial fibrillation (HR 2.76, P = 0.001) and the presence of mild valvular disease (HR 2.69, P = 0.001).
No significant catheter-related complications occurred during the study period, including an absence of ischemic strokes.

Study Design

Type

Cohort (n=125)

Structured PICO

Does pulmonary vein isolation with a ring-shaped ablation catheter (PVAC) prevent recurrence of atrial arrhythmias in patients with paroxysmal or persistent atrial fibrillation?

Population

125 consecutive patients presenting with paroxysmal (78%) or persistent atrial fibrillation

Intervention

Pulmonary vein isolation with a ring-shaped ablation catheter (PVAC, first generation)

Outcome

Composite of atrial fibrillation-related symptoms, ECG documentation of atrial fibrillation or other left atrial arrhythmias, and reablationcomposite

Main Result

Effect estimate: HR 2.76

Absolute Event Rate: 56% vs 28%

p-value: p=0.001

Pulmonary vein isolation with PVAC provides safe and effective long-term freedom from recurrence in paroxysmal atrial fibrillation, but is significantly less effective for persistent atrial fibrillation or in patients with mild valvular disease.

Limitations

Known microembolism issues

Cite This Study

Fredersdorf et al. (2018) conducted a cohort in Paroxysmal or persistent atrial fibrillation (n=125). Pulmonary vein isolation with ring-shaped ablation catheter (PVAC) in paroxysmal AF vs. PVAC in persistent AF was evaluated on Freedom from any recurrence at 72 months (HR 2.76, p=0.001). Pulmonary vein isolation with PVAC was effective for paroxysmal AF, with 56% free from recurrence at 72 months, whereas persistent AF strongly predicted recurrence (HR 2.76, P=0.001).

synapsesocial.com/papers/6a0efda18da6dd046147cc76 https://doi.org/10.2459/jcm.0000000000000631

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes Anticoagulation in AF

View Full Paper

Ask AI

Bookmark

Long-term outcomes and predictors of recurrence after pulmonary vein isolation with multielectrode ablation catheter in patients with atrial fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Long-term outcomes and predictors of recurrence after pulmonary vein isolation with multielectrode ablation catheter in patients with atrial fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider