Early temporal and spatial regularization of persistent atrial fibrillation predicts termination and arrhythmia-free outcome

Background Termination of persistent atrial fibrillation (AF) is a valuable ablation endpoint but is difficult to anticipate. We evaluated whether temporal and spatial indices of AF regularization predict intraprocedural AF termination and outcome. Objective The purpose of this study was to test whe...

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Veröffentlicht in:	Heart rhythm 2011-09, Vol.8 (9), p.1374-1382
Hauptverfasser:	Forclaz, Andrei, MD, Narayan, Sanjiv M., MD, FACC, FHRS, Scherr, Daniel, MD, Linton, Nick, MEng, MRCP, Jadidi, Amir S., MD, Nault, Isabelle, MD, FRCPC, Rivard, Lena, MD, Miyazaki, Shinsuke, MD, Uldry, Laurent, MEng, Wright, Matthew, MBBS, PhD, Shah, Ashok J., MD, Liu, Xingpeng, MD, Xhaet, Olivier, MD, Derval, Nicolas, MD, Knecht, Sébastien, MD, Sacher, Frédéric, MD, Jaïs, Pierre, MD, Hocini, Mélèze, MD, Haïssaguerre, Michel, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Ablation Atrial fibrillation Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Cardiovascular Catheter Ablation - methods Electrophysiologic Techniques, Cardiac Female Heart Conduction System - physiopathology Humans Male Middle Aged Organization Predictive Value of Tests Recurrence ROC Curve Sensitivity and Specificity Signal processing Spectral analysis Termination Treatment Outcome
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Zusammenfassung:	Background Termination of persistent atrial fibrillation (AF) is a valuable ablation endpoint but is difficult to anticipate. We evaluated whether temporal and spatial indices of AF regularization predict intraprocedural AF termination and outcome. Objective The purpose of this study was to test whether temporospatial organization of AF after pulmonary vein isolation (PVI) predicts whether subsequent stepwise ablation will terminate persistent AF or predict outcome. Methods In 75 patients with persistent AF, we measured AF cycle length (AFCL), temporal regularity index (TRI, a spectral measure of timing regularity), and spatial regularity index (SRI, cycle-to-cycle variations in spatial vector) between right atrial appendage and proximal and distal coronary sinus before and during stepwise ablation to the endpoint of AF termination. Results AF termination was achieved in 59 patients (79%) by ablation. AF terminated during PVI in 11 patients, who were excluded from analysis. In the remaining 48 patients, TRI and SRI increased during stepwise ablation, as compared with 16 patients without termination ( P
ISSN:	1547-5271 1556-3871
DOI:	10.1016/j.hrthm.2011.05.008