Prevalence and Predictors of Additional Ablation Beyond Pulmonary Vein Isolation in Patients With Paroxysmal Atrial Fibrillation

Xie, Xin; Yang, Gang; Li, Xiaorong; Yu, Jinbo; Zhang, Fengxiang; Ju, Weizhu; Chen, Hongwu; Li, Mingfang; Gu, Kai; Cheng, Dian; Wang, Xuecheng; Wu, Yizhang; Zhou, Jian; Zhou, Xiaoqian; Zhang, Baowei; Kojodjojo, Pipin; Cao, Kejiang; Yang, Bing; Chen, Minglong

doi:10.3389/fcvm.2021.690297

Cited by 4 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The detailed ablation procedures have been described in our previous study. 15 The ablation was guided by an electroanatomic mapping system (CARTO, BiosenseWebster, CA, USA or EnSiteNavX, St Jude Medical, MN, USA). RFCA was performed by encircling the left-and right-sided pulmonary veins with ablation tips.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of pacemaker implantation within three months after catheter ablation of atrial fibrillation

Guo

Chen

Yang

et al. 2023

Pacing Clinical Electrophis

Self Cite

View full text Add to dashboard Cite

Background: It is inevitable for patients to have a temporary or permanent pacemaker implanted during or after radiofrequency catheter ablation (RFCA) for treatment of atrial fibrillation (AF) in some cases. The aim of our study was to evaluate the incidence of pacemaker implantation (PMI) during or within 3 months of RFCA for AF and to identify the risk factors that were associated with PMI. Methods:We performed a retrospective analysis of consecutive AF patients who underwent RFCA between August 2018 and October 2020 at our center. The incidence of PMI within 3 months during or after RFCA were assessed. A multivariate logistic regression model was performed to identify predictors of PMI.Results: One thousand and five patients (mean age, 60.2 ± 10.3 years; 37.6% women) were included in this analysis. PVI was performed in all patients. A total of 23 (2.3%) patients had a pacemaker implanted within 3 months during or after ablation. Multivariable logistic regression analysis revealed that older age (OR: 1.08 [95% CI 1.03-1.13], p = .003), female sex (OR: 3.08 [95% CI 1.28-7.45], p = .012), paroxysmal AF (OR: 4.71 [95% CI 1.09-20.45], p = .038) and repeated ablation (OR: 2.78 [95% CI 1.04-7.40], p = .041) were the independent predictors for PMI. Conclusions:Older age, female sex, paroxysmal AF and repeated ablation were identified as predictive risk factors for PMI after RFCA in patients with AF. A "watch and wait" strategy could be taken for patients with temporary PMI after ablation, especially for those with prolonged sinus pause after AF termination.

show abstract

Section: Methodsmentioning

confidence: 99%

“…After transseptal puncture of the interatrial septum, intravenous heparin was administered according to institutional standards. The detailed ablation procedures have been described in our previous study 15 . The ablation was guided by an electroanatomic mapping system (CARTO, BiosenseWebster, CA, USA or EnSiteNavX, St Jude Medical, MN, USA).…”

Section: Methodsmentioning

confidence: 99%

Predictors of pacemaker implantation within three months after catheter ablation of atrial fibrillation

Guo

Chen

Yang

et al. 2023

Pacing Clinical Electrophis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Radiofrequency catheter ablation was performed under local anesthesia with intravenous fentanyl and dexmedetomidine. The detailed periprocedural management and ablation strategy has been described previously ( 10 ). In brief, the patient underwent pulmonary vein isolation first and cardioversion was used to restore sinus rhythm.…”

Section: Case Descriptionmentioning

confidence: 99%

Case report: Artery of Percheron infarction as a rare complication during atrial fibrillation ablation

Xie

Wang

et al. 2022

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

The incidence of stroke or transient ischemic attacks (TIA) in atrial fibrillation (AF) catheter ablation procedures is around 1% and may be unnoted under anesthesia. The artery of Percheron (AOP) infarction is a rare kind of stroke with heterogeneity in manifestation, which further makes the perioperative early detection and diagnosis a challenge. Herein, we present one patient who underwent AF ablation and presented mental status alteration after withdrawing anesthetics. An emergency head CT was obtained, which revealed no apparent pathological changes. A late MRI test confirmed the diagnosis of AOP infarction. With oral anticoagulants and rehabilitation therapies, the patient’s awareness improved and fully recovered on the sixth-month follow-up. Variability in manifestation, no positive radiological finding on initial CT, and a low incidence has made few clinicians to gain much experience with this type of infarct, which delays the diagnosis and initiation of appropriate treatment.

show abstract

“…Hence, meticulous atrial mapping is a necessary step during each ablation procedure whether or not non-PV ablation takes place. With that being said, the AF confrontation is not limited to PVI but requires a detailed and in depth analysis of the substrate modification provoked by PVI, in order to plan efficiently the personalized follow-up strategy and reduce the possibility of AF recurrence [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Splitting the P-Wave: Improved Evaluation of Left Atrial Substrate Modification after Pulmonary Vein Isolation of Paroxysmal Atrial Fibrillation

Vraka

Bertomeu-González

Hornero

et al. 2021

Sensors

View full text Add to dashboard Cite

Atrial substrate modification after pulmonary vein isolation (PVI) of paroxysmal atrial fibrillation (pAF) can be assessed non-invasively by analyzing P-wave duration in the electrocardiogram (ECG). However, whether right (RA) and left atrium (LA) contribute equally to this phenomenon remains unknown. The present study splits fundamental P-wave features to investigate the different RA and LA contributions to P-wave duration. Recordings of 29 pAF patients undergoing first-ever PVI were acquired before and after PVI. P-wave features were calculated: P-wave duration (PWD), duration of the first (PWDon-peak) and second (PWDpeak-off) P-wave halves, estimating RA and LA conduction, respectively. P-wave onset (PWon-R) or offset (PWoff-R) to R-peak interval, measuring combined atrial/atrioventricular and single atrioventricular conduction, respectively. Heart-rate fluctuation was corrected by scaling. Pre- and post-PVI results were compared with Mann–Whitney U-test. PWD was correlated with the remaining features. Only PWD (non-scaling: Δ=−9.84%, p=0.0085, scaling: Δ=−17.96%, p=0.0442) and PWDpeak-off (non-scaling: Δ=−22.03%, p=0.0250, scaling: Δ=−27.77%, p=0.0268) were decreased. Correlation of all features with PWD was significant before/after PVI (p<0.0001), showing the highest value between PWD and PWon-R (ρmax=0.855). PWD correlated more with PWDon-peak (ρ= 0.540–0.805) than PWDpeak-off (ρ= 0.419–0.710). PWD shortening after PVI of pAF stems mainly from the second half of the P-wave. Therefore, noninvasive estimation of LA conduction time is critical for the study of atrial substrate modification after PVI and should be addressed by splitting the P-wave in order to achieve improved estimations.

show abstract

Prevalence and Predictors of Additional Ablation Beyond Pulmonary Vein Isolation in Patients With Paroxysmal Atrial Fibrillation

Cited by 4 publications

References 34 publications

Predictors of pacemaker implantation within three months after catheter ablation of atrial fibrillation

Predictors of pacemaker implantation within three months after catheter ablation of atrial fibrillation

Case report: Artery of Percheron infarction as a rare complication during atrial fibrillation ablation

Splitting the P-Wave: Improved Evaluation of Left Atrial Substrate Modification after Pulmonary Vein Isolation of Paroxysmal Atrial Fibrillation

Contact Info

Product

Resources

About