Key result
A stepwise approach to radiofrequency ablation achieved a general efficacy of 76.47% compared to 36.67% with a single pulmonary vein isolation procedure in patients with idiopathic persistent atrial fibrillation.
Why the study?
The study was conducted to evaluate the efficacy of a stepwise approach in the treatment of idiopathic persistent atrial fibrillation.
Does a stepwise approach to radiofrequency ablation improve efficacy in patients with idiopathic persistent atrial fibrillation?
Cohort (n=103)
No
Does a stepwise approach to radiofrequency ablation improve efficacy in patients with idiopathic persistent atrial fibrillation?
A stepwise approach to radiofrequency ablation significantly improves the maintenance of sinus rhythm at 24 months in patients with idiopathic persistent atrial fibrillation compared to a single procedure.
Answers are grounded in this paper and cite their sources.
May support stepwise ablation in idiopathic persistent AF; hypothesis-generating and requires randomized confirmation before practice change.
Objective. To evaluate the efficacy of stepwise approach in treatment of idiopathic persistent atrial fibrillation. Material and methods. The study was held in 2013–2018. The total population of 103 patients was divided into two groups: group of stepwise approach (Group 1) included 43 patients (27 males, 16 females) who under-КЛИНИЧЕСКАЯ went sequential two-step radiofrequency ablation; control group (Group 2) consisted of 60 patients (27 males and 33 females) who underwent just pulmonary veins antral isolation. Follow-up period was 24 months. Results. The reduction of arrhythmogenic substrate with a decrease in both the duration of the complex frac- tionated atrial electrograms by 15.35% to a median of 148 (112; 157) msec, and the total square area of zones of the atrial myocardium with local heterogeneous conduction by 45.3% to a median of 12,49 (10.2; 12.8) cm 2 . General efficacy was 76.47% vs 36.65%, respectively. Conclusion. Staged approach can be useful in reduction of arrhythmogenic substrate as an effective method with the lack of periprocedural complications.
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Ковалев et al. (2019) conducted a cohort in Idiopathic persistent atrial fibrillation (n=103). Stepwise approach (sequential two-step radiofrequency ablation) vs. Single pulmonary vein antral isolation was evaluated on General efficacy (maintenance of sinus rhythm) (p=<0.001). A stepwise approach to radiofrequency ablation achieved a general efficacy of 76.47% compared to 36.67% with a single pulmonary vein isolation procedure in patients with idiopathic persistent atrial fibrillation.
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