Personalized persistent atrial fibrillation ablation guided by left atrial wall thickness: a multicenter study Article Swipe
Giulio Falasconi
,
Diego Penela
,
B Jauregui
,
David Soto‐Iglesias
,
Cheryl Terés
,
Antonio Ordóñez
,
Rodolfo San Antonio
,
Daniel Viveros
,
A Bellido
,
Claudia Scherer
,
J Marti
,
X Sabate
,
María Matiello
,
A Berruezo
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euac053.256
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euac053.256
Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein isolation (PVI) has been proven to be effective in treating persistent atrial fibrillation (PeAF), although long-term ablation outcomes have been significantly less satisfactory than in paroxysmal AF (1). A recent personalized PVI approach, aiming for contiguous lesions with ablation index (AI) titration according to the local left atrial wall thickness (LAWT) as per multidetector cardiac tomography (MDCT), has demonstrated to achieve an arrhythmia-free survival > 95% at 12 months in patients with paroxysmal AF (2). Purpose We sought to investigate the safety and clinical outcomes of this personalized PVI approach guided by LAWT in patients with PeAF. Methods Consecutive patients referred for PeAF first ablation were prospectively enrolled from three referral centers. PeAF was defined in the presence of at least one AF episode sustained beyond 7 days. LAWT three-dimensional maps were obtained from MDCT and integrated into the navigation system. LAWT was categorized into 1 mm layers and AI was titrated to the LAWT. The ablation line was personalized to avoid thicker regions (Figure 1) while encircling PV antrum. Follow-up was scheduled at 1, 3, 6, and every 12-months thereafter. Results One hundred twenty-seven patients [89 (70.6%) male, age 64 ± 10 years] were included. 68 (60.7%) patients were hypertensive, 10 (18%) patients suffered of type 2 diabetes, and mean CHA2DS2-VASc score was 2.3 ± 2.1. Mean procedure time was 61 ± 20 minutes and mean fluoroscopy time was 1.3 ± 2.2 minutes. Radiofrequency (RF) time was 9.0 ± 2.3 minutes for the right pulmonary veins with a first-pass isolation in 109 (85.8%) patients and 7.6 ± 1.9 minutes for the left pulmonary veins with first-pass in 110 (86.6%). No major complication occurred. The rate of survival free from AF recurrences at a mean follow-up of 12 ± 6 months was 82% (Figure 2). Conclusions Personalized Persistent AF ablation by wide circle PV isolation guided by LAWT, proved to be safe and highly efficient, requiring a low amount of RF delivery, procedure time, and fluoroscopy use, while obtaining a high rate of first-pass isolation and of freedom from AF recurrences.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/europace/euac053.256
- https://academic.oup.com/europace/article-pdf/24/Supplement_1/euac053.256/43769862/euac053.256.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4280622676
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4280622676Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/europace/euac053.256Digital Object Identifier
- Title
-
Personalized persistent atrial fibrillation ablation guided by left atrial wall thickness: a multicenter studyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-05-18Full publication date if available
- Authors
-
Giulio Falasconi, Diego Penela, B Jauregui, David Soto‐Iglesias, Cheryl Terés, Antonio Ordóñez, Rodolfo San Antonio, Daniel Viveros, A Bellido, Claudia Scherer, J Marti, X Sabate, María Matiello, A BerruezoList of authors in order
- Landing page
-
https://doi.org/10.1093/europace/euac053.256Publisher landing page
- PDF URL
-
https://academic.oup.com/europace/article-pdf/24/Supplement_1/euac053.256/43769862/euac053.256.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
-
https://academic.oup.com/europace/article-pdf/24/Supplement_1/euac053.256/43769862/euac053.256.pdfDirect OA link when available
- Concepts
-
Medicine, Atrial fibrillation, Pulmonary vein, Ablation, Internal medicine, Catheter ablation, Cardiology, Radiofrequency ablation, Fluoroscopy, RadiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- Related works (count)
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10Other works algorithmically related by OpenAlex
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