Ablation of "Background Tachycardia" in Long Standing Atrial Fibrillation: Improving the Outcomes by Unmasking a Residual Atrial Fibrillation Perpetuator

Catheter ablation of long-standing persistent AF (LSAF) remains challenging. Since AF-Nest (AFN) description, we have observed that a stable, protected, fast source firing, namely "Background Tachycardia"(BT), could be hidden beneath the chaotic AF. Following pulmonary vein isolation (PVI)...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of atrial fibrillation 2017-08, Vol.10 (2), p.1583-1583
Hauptverfasser: Pachón-M, José Carlos, Pachón-M, Enrique I, Santillana P, Tomas G, Lobo, Tasso Julio, Pachón, Carlos Thiene C, Pachón-M, Juán Carlos, Albornoz V, Remy Nelson, Zerpa A, Juán Carlos, Ortencio, Felipe, Arruda, Mauricio
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1583
container_issue 2
container_start_page 1583
container_title Journal of atrial fibrillation
container_volume 10
creator Pachón-M, José Carlos
Pachón-M, Enrique I
Santillana P, Tomas G
Lobo, Tasso Julio
Pachón, Carlos Thiene C
Pachón-M, Juán Carlos
Albornoz V, Remy Nelson
Zerpa A, Juán Carlos
Ortencio, Felipe
Arruda, Mauricio
description Catheter ablation of long-standing persistent AF (LSAF) remains challenging. Since AF-Nest (AFN) description, we have observed that a stable, protected, fast source firing, namely "Background Tachycardia"(BT), could be hidden beneath the chaotic AF. Following pulmonary vein isolation (PVI)+AFN ablation one or more BT may arise or be induced in 30-40% of patients, which could be the culprit forAF maintenance and ablation recurrences. We studied 114 patients, from 322 sequential LSAF regular ablations, having spontaneous or induced residual BT after EGM-guided PVI+AFN ablation of LSAF; 55.6±11y/o, 97males (85.1%), EF=65.5±8%, LA=42.8±6.7mm. Macroreentrant tachycardias were excluded. Pre-ablationAF 12-leads ECG Digital processing(DP) and spectral analysis(SA) was performed searching for BT before AF ablation and its correlation with BT during ablation.After PVI, 38.1±9 AFN sites/patient and 135 sustained BTs (1-3, 1.2±0.5/patient) were ablated. BT cycle length(CL) was 246.3±37.3ms. In 79 patients presenting suitable DP for SA, the BT-CL was 241.6±34.3ms with intra procedure BT-CL correlation r=0.83/p
doi_str_mv 10.4022/jafib.1583
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5673289</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1978314835</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2933-284ab5d8eb087c51d76e18e281bba14e948198458ea646689e672bfb53f1f8693</originalsourceid><addsrcrecordid>eNptkVFrFDEQxxdRbK2--AEk9EmEq5tkN5v4IJzFauGgou1zmGRn79LuJmeSLdxH6bftrldLBZ9m4P-f38zwL4q3tDypSsY-XkPnzAmtJX9WHFJV0YVQlD5_0h8Ur1K6LkshBKcviwOmWF0yXh4Wd0vTQ3bBk9CR4y9gb9YxjL4ll2A3OwuxdXBMnCer4NfkVwbfuqlZ5uigJ2fORNfvAZ_I-bCN4XaW8wbJxZhtGDARsyNXfoB0MytAfmJy7TgN_4dBfmDcYh4hh_i6eNFBn_DNQz0qrs6-Xp5-X6wuvp2fLlcLyxTnCyYrMHUr0ZSysTVtG4FUIpPUGKAVqkpSJataIohKCKlQNMx0puYd7aRQ_Kj4vOduRzNga9HnCL3eRjdA3OkATv-reLfR63Cra9FwJmfA-wdADL9HTFkPLlmcXvIYxqSpaiSnleT1ZP2wt9oYUorYPa6hpZ6z1H-y1HOWk_nd08MerX_D4_efP525</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1978314835</pqid></control><display><type>article</type><title>Ablation of "Background Tachycardia" in Long Standing Atrial Fibrillation: Improving the Outcomes by Unmasking a Residual Atrial Fibrillation Perpetuator</title><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Pachón-M, José Carlos ; Pachón-M, Enrique I ; Santillana P, Tomas G ; Lobo, Tasso Julio ; Pachón, Carlos Thiene C ; Pachón-M, Juán Carlos ; Albornoz V, Remy Nelson ; Zerpa A, Juán Carlos ; Ortencio, Felipe ; Arruda, Mauricio</creator><creatorcontrib>Pachón-M, José Carlos ; Pachón-M, Enrique I ; Santillana P, Tomas G ; Lobo, Tasso Julio ; Pachón, Carlos Thiene C ; Pachón-M, Juán Carlos ; Albornoz V, Remy Nelson ; Zerpa A, Juán Carlos ; Ortencio, Felipe ; Arruda, Mauricio</creatorcontrib><description>Catheter ablation of long-standing persistent AF (LSAF) remains challenging. Since AF-Nest (AFN) description, we have observed that a stable, protected, fast source firing, namely "Background Tachycardia"(BT), could be hidden beneath the chaotic AF. Following pulmonary vein isolation (PVI)+AFN ablation one or more BT may arise or be induced in 30-40% of patients, which could be the culprit forAF maintenance and ablation recurrences. We studied 114 patients, from 322 sequential LSAF regular ablations, having spontaneous or induced residual BT after EGM-guided PVI+AFN ablation of LSAF; 55.6±11y/o, 97males (85.1%), EF=65.5±8%, LA=42.8±6.7mm. Macroreentrant tachycardias were excluded. Pre-ablationAF 12-leads ECG Digital processing(DP) and spectral analysis(SA) was performed searching for BT before AF ablation and its correlation with BT during ablation.After PVI, 38.1±9 AFN sites/patient and 135 sustained BTs (1-3, 1.2±0.5/patient) were ablated. BT cycle length(CL) was 246.3±37.3ms. In 79 patients presenting suitable DP for SA, the BT-CL was 241.6±34.3ms with intra procedure BT-CL correlation r=0.83/p&lt;0.01. Following BT ablation, AF could not be induced. During FU of 13→60 months(22.8±12m), AF freedom for BT RF(+) vs. BT RF(-) groups were 77.9% vs. 56.4% (p=0.009), respectively. There was no significant complication. BT ablation following PVI and AFN ablation improved long-term outcomes ofLSAF ablation. BT is likely due to sustained microreentry, protected during AF by entry block. BT can be suspected by spectral analysis of the pre-ablation ECG and is likely one important AF perpetuator by causing electrical resonance of the AFN. This ablation strategy warrants randomized, multicenter investigation.</description><identifier>ISSN: 1941-6911</identifier><identifier>EISSN: 1941-6911</identifier><identifier>DOI: 10.4022/jafib.1583</identifier><identifier>PMID: 29250230</identifier><language>eng</language><publisher>United States: Cardiofront, Inc</publisher><subject>Original Research</subject><ispartof>Journal of atrial fibrillation, 2017-08, Vol.10 (2), p.1583-1583</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2933-284ab5d8eb087c51d76e18e281bba14e948198458ea646689e672bfb53f1f8693</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5673289/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5673289/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29250230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pachón-M, José Carlos</creatorcontrib><creatorcontrib>Pachón-M, Enrique I</creatorcontrib><creatorcontrib>Santillana P, Tomas G</creatorcontrib><creatorcontrib>Lobo, Tasso Julio</creatorcontrib><creatorcontrib>Pachón, Carlos Thiene C</creatorcontrib><creatorcontrib>Pachón-M, Juán Carlos</creatorcontrib><creatorcontrib>Albornoz V, Remy Nelson</creatorcontrib><creatorcontrib>Zerpa A, Juán Carlos</creatorcontrib><creatorcontrib>Ortencio, Felipe</creatorcontrib><creatorcontrib>Arruda, Mauricio</creatorcontrib><title>Ablation of "Background Tachycardia" in Long Standing Atrial Fibrillation: Improving the Outcomes by Unmasking a Residual Atrial Fibrillation Perpetuator</title><title>Journal of atrial fibrillation</title><addtitle>J Atr Fibrillation</addtitle><description>Catheter ablation of long-standing persistent AF (LSAF) remains challenging. Since AF-Nest (AFN) description, we have observed that a stable, protected, fast source firing, namely "Background Tachycardia"(BT), could be hidden beneath the chaotic AF. Following pulmonary vein isolation (PVI)+AFN ablation one or more BT may arise or be induced in 30-40% of patients, which could be the culprit forAF maintenance and ablation recurrences. We studied 114 patients, from 322 sequential LSAF regular ablations, having spontaneous or induced residual BT after EGM-guided PVI+AFN ablation of LSAF; 55.6±11y/o, 97males (85.1%), EF=65.5±8%, LA=42.8±6.7mm. Macroreentrant tachycardias were excluded. Pre-ablationAF 12-leads ECG Digital processing(DP) and spectral analysis(SA) was performed searching for BT before AF ablation and its correlation with BT during ablation.After PVI, 38.1±9 AFN sites/patient and 135 sustained BTs (1-3, 1.2±0.5/patient) were ablated. BT cycle length(CL) was 246.3±37.3ms. In 79 patients presenting suitable DP for SA, the BT-CL was 241.6±34.3ms with intra procedure BT-CL correlation r=0.83/p&lt;0.01. Following BT ablation, AF could not be induced. During FU of 13→60 months(22.8±12m), AF freedom for BT RF(+) vs. BT RF(-) groups were 77.9% vs. 56.4% (p=0.009), respectively. There was no significant complication. BT ablation following PVI and AFN ablation improved long-term outcomes ofLSAF ablation. BT is likely due to sustained microreentry, protected during AF by entry block. BT can be suspected by spectral analysis of the pre-ablation ECG and is likely one important AF perpetuator by causing electrical resonance of the AFN. This ablation strategy warrants randomized, multicenter investigation.</description><subject>Original Research</subject><issn>1941-6911</issn><issn>1941-6911</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNptkVFrFDEQxxdRbK2--AEk9EmEq5tkN5v4IJzFauGgou1zmGRn79LuJmeSLdxH6bftrldLBZ9m4P-f38zwL4q3tDypSsY-XkPnzAmtJX9WHFJV0YVQlD5_0h8Ur1K6LkshBKcviwOmWF0yXh4Wd0vTQ3bBk9CR4y9gb9YxjL4ll2A3OwuxdXBMnCer4NfkVwbfuqlZ5uigJ2fORNfvAZ_I-bCN4XaW8wbJxZhtGDARsyNXfoB0MytAfmJy7TgN_4dBfmDcYh4hh_i6eNFBn_DNQz0qrs6-Xp5-X6wuvp2fLlcLyxTnCyYrMHUr0ZSysTVtG4FUIpPUGKAVqkpSJataIohKCKlQNMx0puYd7aRQ_Kj4vOduRzNga9HnCL3eRjdA3OkATv-reLfR63Cra9FwJmfA-wdADL9HTFkPLlmcXvIYxqSpaiSnleT1ZP2wt9oYUorYPa6hpZ6z1H-y1HOWk_nd08MerX_D4_efP525</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Pachón-M, José Carlos</creator><creator>Pachón-M, Enrique I</creator><creator>Santillana P, Tomas G</creator><creator>Lobo, Tasso Julio</creator><creator>Pachón, Carlos Thiene C</creator><creator>Pachón-M, Juán Carlos</creator><creator>Albornoz V, Remy Nelson</creator><creator>Zerpa A, Juán Carlos</creator><creator>Ortencio, Felipe</creator><creator>Arruda, Mauricio</creator><general>Cardiofront, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170801</creationdate><title>Ablation of "Background Tachycardia" in Long Standing Atrial Fibrillation: Improving the Outcomes by Unmasking a Residual Atrial Fibrillation Perpetuator</title><author>Pachón-M, José Carlos ; Pachón-M, Enrique I ; Santillana P, Tomas G ; Lobo, Tasso Julio ; Pachón, Carlos Thiene C ; Pachón-M, Juán Carlos ; Albornoz V, Remy Nelson ; Zerpa A, Juán Carlos ; Ortencio, Felipe ; Arruda, Mauricio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2933-284ab5d8eb087c51d76e18e281bba14e948198458ea646689e672bfb53f1f8693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Original Research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pachón-M, José Carlos</creatorcontrib><creatorcontrib>Pachón-M, Enrique I</creatorcontrib><creatorcontrib>Santillana P, Tomas G</creatorcontrib><creatorcontrib>Lobo, Tasso Julio</creatorcontrib><creatorcontrib>Pachón, Carlos Thiene C</creatorcontrib><creatorcontrib>Pachón-M, Juán Carlos</creatorcontrib><creatorcontrib>Albornoz V, Remy Nelson</creatorcontrib><creatorcontrib>Zerpa A, Juán Carlos</creatorcontrib><creatorcontrib>Ortencio, Felipe</creatorcontrib><creatorcontrib>Arruda, Mauricio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of atrial fibrillation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pachón-M, José Carlos</au><au>Pachón-M, Enrique I</au><au>Santillana P, Tomas G</au><au>Lobo, Tasso Julio</au><au>Pachón, Carlos Thiene C</au><au>Pachón-M, Juán Carlos</au><au>Albornoz V, Remy Nelson</au><au>Zerpa A, Juán Carlos</au><au>Ortencio, Felipe</au><au>Arruda, Mauricio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ablation of "Background Tachycardia" in Long Standing Atrial Fibrillation: Improving the Outcomes by Unmasking a Residual Atrial Fibrillation Perpetuator</atitle><jtitle>Journal of atrial fibrillation</jtitle><addtitle>J Atr Fibrillation</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>10</volume><issue>2</issue><spage>1583</spage><epage>1583</epage><pages>1583-1583</pages><issn>1941-6911</issn><eissn>1941-6911</eissn><abstract>Catheter ablation of long-standing persistent AF (LSAF) remains challenging. Since AF-Nest (AFN) description, we have observed that a stable, protected, fast source firing, namely "Background Tachycardia"(BT), could be hidden beneath the chaotic AF. Following pulmonary vein isolation (PVI)+AFN ablation one or more BT may arise or be induced in 30-40% of patients, which could be the culprit forAF maintenance and ablation recurrences. We studied 114 patients, from 322 sequential LSAF regular ablations, having spontaneous or induced residual BT after EGM-guided PVI+AFN ablation of LSAF; 55.6±11y/o, 97males (85.1%), EF=65.5±8%, LA=42.8±6.7mm. Macroreentrant tachycardias were excluded. Pre-ablationAF 12-leads ECG Digital processing(DP) and spectral analysis(SA) was performed searching for BT before AF ablation and its correlation with BT during ablation.After PVI, 38.1±9 AFN sites/patient and 135 sustained BTs (1-3, 1.2±0.5/patient) were ablated. BT cycle length(CL) was 246.3±37.3ms. In 79 patients presenting suitable DP for SA, the BT-CL was 241.6±34.3ms with intra procedure BT-CL correlation r=0.83/p&lt;0.01. Following BT ablation, AF could not be induced. During FU of 13→60 months(22.8±12m), AF freedom for BT RF(+) vs. BT RF(-) groups were 77.9% vs. 56.4% (p=0.009), respectively. There was no significant complication. BT ablation following PVI and AFN ablation improved long-term outcomes ofLSAF ablation. BT is likely due to sustained microreentry, protected during AF by entry block. BT can be suspected by spectral analysis of the pre-ablation ECG and is likely one important AF perpetuator by causing electrical resonance of the AFN. This ablation strategy warrants randomized, multicenter investigation.</abstract><cop>United States</cop><pub>Cardiofront, Inc</pub><pmid>29250230</pmid><doi>10.4022/jafib.1583</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1941-6911
ispartof Journal of atrial fibrillation, 2017-08, Vol.10 (2), p.1583-1583
issn 1941-6911
1941-6911
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5673289
source EZB-FREE-00999 freely available EZB journals; PubMed Central
subjects Original Research
title Ablation of "Background Tachycardia" in Long Standing Atrial Fibrillation: Improving the Outcomes by Unmasking a Residual Atrial Fibrillation Perpetuator
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-10T05%3A01%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ablation%20of%20%22Background%20Tachycardia%22%20in%20Long%20Standing%20Atrial%20Fibrillation:%20Improving%20the%20Outcomes%20by%20Unmasking%20a%20Residual%20Atrial%20Fibrillation%20Perpetuator&rft.jtitle=Journal%20of%20atrial%20fibrillation&rft.au=Pach%C3%B3n-M,%20Jos%C3%A9%20Carlos&rft.date=2017-08-01&rft.volume=10&rft.issue=2&rft.spage=1583&rft.epage=1583&rft.pages=1583-1583&rft.issn=1941-6911&rft.eissn=1941-6911&rft_id=info:doi/10.4022/jafib.1583&rft_dat=%3Cproquest_pubme%3E1978314835%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1978314835&rft_id=info:pmid/29250230&rfr_iscdi=true