Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation
Aims Pulmonary vein isolation (PVI) is an effective procedure for atrial fibrillation (AF). The role of additional cavotricuspid isthmus (CTI) block ablation remains controversial in AF patients without atrial flutter (AFL). Therefore, this study aimed to explore the clinical outcome of additional C...
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| Veröffentlicht in: | Pacing and clinical electrophysiology 2019-11, Vol.42 (11), p.1421-1428 |
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| container_title | Pacing and clinical electrophysiology |
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| creator | Lee, Wei‐Chieh Fang, Hsiu‐Yu Chen, Huang‐Chung Chen, Yung‐Lung Tsai, Tzu‐Hsien Pan, Kuo‐Li Lin, Yu‐Sheng Chen, Mien‐Cheng |
| description | Aims
Pulmonary vein isolation (PVI) is an effective procedure for atrial fibrillation (AF). The role of additional cavotricuspid isthmus (CTI) block ablation remains controversial in AF patients without atrial flutter (AFL). Therefore, this study aimed to explore the clinical outcome of additional CTI block ablation in patients without AFL.
Methods
Between January 2013 and December 2017, a total of 139 patients who did not have documented AFL and who underwent catheter ablation for AF were recruited. Fifty‐seven patients were classified in additional CTI block ablation group and 82 patients were classified in without CTI group. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence was compared between the two groups.
Results
The additional CTI group had a higher prevalence of persistent or long‐standing AF and larger left atrial volume. The additional CTI group had a higher incidence of late‐onset atrial arrhythmia recurrence (38.6% vs 12.2%; P |
| doi_str_mv | 10.1111/pace.13799 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2284562097</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2284562097</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3579-98f71f16c9d7e461cfc669f1d70a88f411034705edf8f5587e71e9abf4462cf13</originalsourceid><addsrcrecordid>eNp9kT1PwzAQhi0EouVj4QcgSywIKeCL7dgeq6p8SJVggDlyHFsYkrrESVH_PS4tDAzccsvzPjrdi9AZkGtIc7PUxl4DFUrtoTFwRjIJXO2jMQEmMkmlGqGjGN8IIQVh_BCNKDCZcyHH6H1S1773YaEbbPQq9J03Q1z6GvvYv7ZDxFUTzDvWVaM3GG71Gi9Cj3277MLK4v7V4jD0JrRpO6yTIKmcrzrf7CI_2RN04HQT7eluH6OX29nz9D6bP949TCfzzFAuVKakE-CgMKoWlhVgnCkK5aAWREvpGAChTBBuaycd51JYAVbpyjFW5MYBPUaXW2-68GOwsS9bH41N5yxsGGKZ55LxIidKJPTiD_oWhi49I1E0ASpnlCbqakuZLsTYWVcuO9_qbl0CKTcVlJsKyu8KEny-Uw5Va-tf9OfnCYAt8Okbu_5HVT5NprOt9AvNy5If</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2309792433</pqid></control><display><type>article</type><title>Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation</title><source>Access via Wiley Online Library</source><creator>Lee, Wei‐Chieh ; Fang, Hsiu‐Yu ; Chen, Huang‐Chung ; Chen, Yung‐Lung ; Tsai, Tzu‐Hsien ; Pan, Kuo‐Li ; Lin, Yu‐Sheng ; Chen, Mien‐Cheng</creator><creatorcontrib>Lee, Wei‐Chieh ; Fang, Hsiu‐Yu ; Chen, Huang‐Chung ; Chen, Yung‐Lung ; Tsai, Tzu‐Hsien ; Pan, Kuo‐Li ; Lin, Yu‐Sheng ; Chen, Mien‐Cheng</creatorcontrib><description>Aims
Pulmonary vein isolation (PVI) is an effective procedure for atrial fibrillation (AF). The role of additional cavotricuspid isthmus (CTI) block ablation remains controversial in AF patients without atrial flutter (AFL). Therefore, this study aimed to explore the clinical outcome of additional CTI block ablation in patients without AFL.
Methods
Between January 2013 and December 2017, a total of 139 patients who did not have documented AFL and who underwent catheter ablation for AF were recruited. Fifty‐seven patients were classified in additional CTI block ablation group and 82 patients were classified in without CTI group. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence was compared between the two groups.
Results
The additional CTI group had a higher prevalence of persistent or long‐standing AF and larger left atrial volume. The additional CTI group had a higher incidence of late‐onset atrial arrhythmia recurrence (38.6% vs 12.2%; P < .001). When compared to without CTI group, additional CTI therapy did not have a better outcome in terms of freedom of atrial arrhythmia in subgroup analysis. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence did not differ between additional CTI group and without CTI group in paroxysmal AF patients and nonparoxysmal AF patients after propensity scoring matching.
Conclusion
CTI block ablation in addition to PVI for AF patients without a history of AFL or inducible AFL during ablation may not improve the clinical outcome of AF ablation in the patients with larger LA volume, nonparoxysmal AF, or post‐PVI inducible AF.</description><identifier>ISSN: 0147-8389</identifier><identifier>EISSN: 1540-8159</identifier><identifier>DOI: 10.1111/pace.13799</identifier><identifier>PMID: 31482578</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>additional cavotricuspid isthmus block ablation ; Arrhythmia ; atrial arrhythmia recurrence ; atrial fibrillation ablation ; atrial flutter ; Cardiac arrhythmia ; Catheters ; Fibrillation</subject><ispartof>Pacing and clinical electrophysiology, 2019-11, Vol.42 (11), p.1421-1428</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3579-98f71f16c9d7e461cfc669f1d70a88f411034705edf8f5587e71e9abf4462cf13</citedby><cites>FETCH-LOGICAL-c3579-98f71f16c9d7e461cfc669f1d70a88f411034705edf8f5587e71e9abf4462cf13</cites><orcidid>0000-0003-0585-6134</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpace.13799$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpace.13799$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27928,27929,45578,45579</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31482578$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Wei‐Chieh</creatorcontrib><creatorcontrib>Fang, Hsiu‐Yu</creatorcontrib><creatorcontrib>Chen, Huang‐Chung</creatorcontrib><creatorcontrib>Chen, Yung‐Lung</creatorcontrib><creatorcontrib>Tsai, Tzu‐Hsien</creatorcontrib><creatorcontrib>Pan, Kuo‐Li</creatorcontrib><creatorcontrib>Lin, Yu‐Sheng</creatorcontrib><creatorcontrib>Chen, Mien‐Cheng</creatorcontrib><title>Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation</title><title>Pacing and clinical electrophysiology</title><addtitle>Pacing Clin Electrophysiol</addtitle><description>Aims
Pulmonary vein isolation (PVI) is an effective procedure for atrial fibrillation (AF). The role of additional cavotricuspid isthmus (CTI) block ablation remains controversial in AF patients without atrial flutter (AFL). Therefore, this study aimed to explore the clinical outcome of additional CTI block ablation in patients without AFL.
Methods
Between January 2013 and December 2017, a total of 139 patients who did not have documented AFL and who underwent catheter ablation for AF were recruited. Fifty‐seven patients were classified in additional CTI block ablation group and 82 patients were classified in without CTI group. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence was compared between the two groups.
Results
The additional CTI group had a higher prevalence of persistent or long‐standing AF and larger left atrial volume. The additional CTI group had a higher incidence of late‐onset atrial arrhythmia recurrence (38.6% vs 12.2%; P < .001). When compared to without CTI group, additional CTI therapy did not have a better outcome in terms of freedom of atrial arrhythmia in subgroup analysis. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence did not differ between additional CTI group and without CTI group in paroxysmal AF patients and nonparoxysmal AF patients after propensity scoring matching.
Conclusion
CTI block ablation in addition to PVI for AF patients without a history of AFL or inducible AFL during ablation may not improve the clinical outcome of AF ablation in the patients with larger LA volume, nonparoxysmal AF, or post‐PVI inducible AF.</description><subject>additional cavotricuspid isthmus block ablation</subject><subject>Arrhythmia</subject><subject>atrial arrhythmia recurrence</subject><subject>atrial fibrillation ablation</subject><subject>atrial flutter</subject><subject>Cardiac arrhythmia</subject><subject>Catheters</subject><subject>Fibrillation</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kT1PwzAQhi0EouVj4QcgSywIKeCL7dgeq6p8SJVggDlyHFsYkrrESVH_PS4tDAzccsvzPjrdi9AZkGtIc7PUxl4DFUrtoTFwRjIJXO2jMQEmMkmlGqGjGN8IIQVh_BCNKDCZcyHH6H1S1773YaEbbPQq9J03Q1z6GvvYv7ZDxFUTzDvWVaM3GG71Gi9Cj3277MLK4v7V4jD0JrRpO6yTIKmcrzrf7CI_2RN04HQT7eluH6OX29nz9D6bP949TCfzzFAuVKakE-CgMKoWlhVgnCkK5aAWREvpGAChTBBuaycd51JYAVbpyjFW5MYBPUaXW2-68GOwsS9bH41N5yxsGGKZ55LxIidKJPTiD_oWhi49I1E0ASpnlCbqakuZLsTYWVcuO9_qbl0CKTcVlJsKyu8KEny-Uw5Va-tf9OfnCYAt8Okbu_5HVT5NprOt9AvNy5If</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Lee, Wei‐Chieh</creator><creator>Fang, Hsiu‐Yu</creator><creator>Chen, Huang‐Chung</creator><creator>Chen, Yung‐Lung</creator><creator>Tsai, Tzu‐Hsien</creator><creator>Pan, Kuo‐Li</creator><creator>Lin, Yu‐Sheng</creator><creator>Chen, Mien‐Cheng</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0585-6134</orcidid></search><sort><creationdate>201911</creationdate><title>Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation</title><author>Lee, Wei‐Chieh ; Fang, Hsiu‐Yu ; Chen, Huang‐Chung ; Chen, Yung‐Lung ; Tsai, Tzu‐Hsien ; Pan, Kuo‐Li ; Lin, Yu‐Sheng ; Chen, Mien‐Cheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3579-98f71f16c9d7e461cfc669f1d70a88f411034705edf8f5587e71e9abf4462cf13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>additional cavotricuspid isthmus block ablation</topic><topic>Arrhythmia</topic><topic>atrial arrhythmia recurrence</topic><topic>atrial fibrillation ablation</topic><topic>atrial flutter</topic><topic>Cardiac arrhythmia</topic><topic>Catheters</topic><topic>Fibrillation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Wei‐Chieh</creatorcontrib><creatorcontrib>Fang, Hsiu‐Yu</creatorcontrib><creatorcontrib>Chen, Huang‐Chung</creatorcontrib><creatorcontrib>Chen, Yung‐Lung</creatorcontrib><creatorcontrib>Tsai, Tzu‐Hsien</creatorcontrib><creatorcontrib>Pan, Kuo‐Li</creatorcontrib><creatorcontrib>Lin, Yu‐Sheng</creatorcontrib><creatorcontrib>Chen, Mien‐Cheng</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pacing and clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Wei‐Chieh</au><au>Fang, Hsiu‐Yu</au><au>Chen, Huang‐Chung</au><au>Chen, Yung‐Lung</au><au>Tsai, Tzu‐Hsien</au><au>Pan, Kuo‐Li</au><au>Lin, Yu‐Sheng</au><au>Chen, Mien‐Cheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation</atitle><jtitle>Pacing and clinical electrophysiology</jtitle><addtitle>Pacing Clin Electrophysiol</addtitle><date>2019-11</date><risdate>2019</risdate><volume>42</volume><issue>11</issue><spage>1421</spage><epage>1428</epage><pages>1421-1428</pages><issn>0147-8389</issn><eissn>1540-8159</eissn><abstract>Aims
Pulmonary vein isolation (PVI) is an effective procedure for atrial fibrillation (AF). The role of additional cavotricuspid isthmus (CTI) block ablation remains controversial in AF patients without atrial flutter (AFL). Therefore, this study aimed to explore the clinical outcome of additional CTI block ablation in patients without AFL.
Methods
Between January 2013 and December 2017, a total of 139 patients who did not have documented AFL and who underwent catheter ablation for AF were recruited. Fifty‐seven patients were classified in additional CTI block ablation group and 82 patients were classified in without CTI group. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence was compared between the two groups.
Results
The additional CTI group had a higher prevalence of persistent or long‐standing AF and larger left atrial volume. The additional CTI group had a higher incidence of late‐onset atrial arrhythmia recurrence (38.6% vs 12.2%; P < .001). When compared to without CTI group, additional CTI therapy did not have a better outcome in terms of freedom of atrial arrhythmia in subgroup analysis. The incidence of early‐onset and late‐onset atrial arrhythmia recurrence did not differ between additional CTI group and without CTI group in paroxysmal AF patients and nonparoxysmal AF patients after propensity scoring matching.
Conclusion
CTI block ablation in addition to PVI for AF patients without a history of AFL or inducible AFL during ablation may not improve the clinical outcome of AF ablation in the patients with larger LA volume, nonparoxysmal AF, or post‐PVI inducible AF.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31482578</pmid><doi>10.1111/pace.13799</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0585-6134</orcidid></addata></record> |
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| issn | 0147-8389 1540-8159 |
| language | eng |
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| source | Access via Wiley Online Library |
| subjects | additional cavotricuspid isthmus block ablation Arrhythmia atrial arrhythmia recurrence atrial fibrillation ablation atrial flutter Cardiac arrhythmia Catheters Fibrillation |
| title | Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation |
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