Rate versus rhythm control strategies for AF

Olshansky, Brian

doi:10.1007/s11936-005-0021-3

Cited by 1 publication

(1 citation statement)

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“…Left atrial enlargement has been shown to be associated with an inversed rate of AF recurrence after chemical or electrical cardioversion [4] . Previous studies have shown that an increase in the LA diameter is associated with higher AF prevalence; moreover LA diameter is an independent risk factor in the development of AF, and in determining the long-term outcomes of ablation [5] .…”

Section: Introductionmentioning

confidence: 99%

Contact-Force Guided Pulmonary Vein Isolation does not Improve Success Rate in Persistent Atrial Fibrillation Patients and Severe Left Atrial Enlargement: A 12-month Follow-Up Study

Gül

Boles

Haseeb

et al. 2018

Journal of Atrial Fibrillation

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Background: Catheter ablation is a cornerstone treatment strategy in atrial fibrillation (AF). Left atrial (LA) size is one of the contributors in development of AF recurrences. The impact of contact-forced (CF) guided catheter ablation on the success rate of persistent AF patients with severe enlarged LA has not been investigated yet. Methods: Sixty-six patients with diagnosis of longstanding persistent AF undergoing catheter ablation were enrolled. All patients underwent a standard transthoracic echocardiography according to the guidelines. LA size was considered severely enlarged when LA diameter was ≥ 50 mm. CF catheter ablation with a Tacticath Quartz catheter (St Jude Medical, St. Paul, MN, USA) was used in all patients. Results: The mean age was 61.9 ± 9.9 years, and LAD 47.8 ± 11.6 mm. Among 66 patients with persistent AF, 32 (48%) patients were diagnosed with AF recurrences. Twenty-eight (42%) patients had severely enlarged LA. The recurrence of AF was comparable in patients with and without severe enlarged LA (47% vs. 42%, p=0.79). The recurrence of AF was lower in patients who underwent CF-guided ablation with a normal LA dimension (36 %, p=0.54). Procedure duration was longer in patients with severely enlarged LA. LA dimension was not significantly different between patients with and without AF recurrence (49.8 ± 7.9 mm vs. 45.9 ± 7.5 mm, p=0.15). LAD and was significantly correlated with the time to recurrence of AF (r:-0.60, p=0.02). Conclusions: Our preliminary findings have demonstrated that CF guided ablation does not improve the success rate in longstanding persistent AF patients with severe LA enlargement.

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Section: Introductionmentioning

confidence: 99%