Pulmonary vein isolation alone using VISITAG SURPOINT achieved 70% freedom from atrial arrhythmias at 1 year, with 88% success in persistent AF patients having <3.24% low-voltage zones.
Cohort (n=140)
Does a pulmonary vein isolation alone strategy using VISITAG SURPOINT prevent atrial tachycardia or atrial fibrillation recurrence in patients with persistent or long-standing persistent atrial fibrillation?
PVI alone using VISITAG SURPOINT is highly effective for persistent AF with low left atrial low-voltage zones, but insufficient for long-standing persistent AF or extensive low-voltage zones.
BACKGROUND: Recent studies have shown the improvement in long-term effectiveness with standardized pulmonary vein isolation (PVI) aimed at creating durable and contiguous lesions with VISITAG SURPOINT (VS) in paroxysmal atrial fibrillation (PAF). OBJECTIVE: We aimed to assess efficacy of PVI alone strategy using VS in non-PAF patients and evaluate factors associated with corresponding clinical outcomes. METHODS: Consecutive patients who underwent PVI for persistent/long-standing persistent AF between May 2017 to July 2019 were studied retrospectively. PVI was performed with 30-50 W guided by VS (posterior target: 400-500, anterior target: 500). Left atrial voltage maps were created during atrial pacing after PVI. RESULTS: A total of 140 patients (119 males, age 62 ± 10 years, long-standing persistent AF: 35) were included and followed for median of 454 days. No adverse events were reported in any patients during periprocedural and follow-up period of up to 28 months. Kaplan-Meier analysis estimated that freedom from atrial tachycardia or AF (AT/AF) without antiarrhythmics at 1-year was 70%. Radiofrequency delivery with higher power was associated with increased first-pass isolation rate, but not with freedom from AT/AF. In multivariate analysis, long-standing persistent AF and % low-voltage zone (%LVZ) were independent predictors of clinical outcome. The best cut-off value of %LVZ for predicting AT/AF recurrence was 3.24%. Freedom from AT/AF was 88% in patients with persistent AF and %LVZ < 3.24%, while 27% in those with long-standing persistent AF and %LVZ ≥ 3.24%. CONCLUSIONS: PVI alone using VS was associated with excellent 1-year success in patients with persistent AF and %LVZ < 3.24%, but was insufficient in those with long-standing persistent AF and/or %LVZ ≥ 3.24%.
Yamaguchi et al. (Wed,) conducted a cohort in Persistent or long-standing persistent atrial fibrillation (n=140). Pulmonary vein isolation alone using VISITAG SURPOINT was evaluated on Freedom from atrial tachycardia or AF (AT/AF) without antiarrhythmics at 1-year. Pulmonary vein isolation alone using VISITAG SURPOINT achieved 70% freedom from atrial arrhythmias at 1 year, with 88% success in persistent AF patients having <3.24% low-voltage zones.