The Different Mechanisms Between Late and Very Late Recurrences of Atrial Fibrillation in Patients Undergoing a Repeated Catheter Ablation

Hsieh, Ming-Hsiung; Tai, Ching-Tai; Lee, Shih-Huang; Lin, Yung Kuo; Tsao, Hsuan-Ming; Chang, Shih-Lin; Lin, Yenn-Jiang; Wongchaoen, Wanwarang; Lee, Kun-Tai; Chen, Shih-Ann

doi:10.1111/j.1540-8167.2005.00323.x

Cited by 76 publications

(81 citation statements)

References 22 publications

(53 reference statements)

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“…The incidence of non-PV foci in our VLRAF group (66.7%) was significantly higher than the incidence reported in other studies. 10,11 This discrepancy may be explained by the different ablation algorithm of CPVA in our study. Different than those studies, we only performed CPVA and PV isolation and did not perform extra operations in the initial procedure (e.g., non-PV foci mapping and inductive maneuver of ATa after PV isolation).…”

Section: Vlraf After Catheter Ablationcontrasting

confidence: 39%

“…Heish et al observed that the incidence of VLRAF was 6% 9 and demonstrated that non-PV foci were the essential trigger for VLRAF. 10 Recently, Mainigi et al 11 reported a similar incidence of VLRAF (7.9%) and demonstrated that obese weight was a predictor for VLRAF. In our study, the low incidence of VLRAF (5.6%) was consistent with these studies, and the clinical characteristic most likely to predict VLRAF was the presence of ERAF.…”

Section: Vlraf After Catheter Ablationmentioning

confidence: 95%

“…For patients with VLRAF, why did their ATa recurrence occur so late? Some studies 10,11 showed VLRAF associated with the existence of non-PV foci. Furthermore, the anatomic character of non-PV foci is prone to delay the recurrence.…”

Section: Vlraf After Catheter Ablationmentioning

confidence: 99%

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Predictors of Very Late Recurrence of Atrial Fibrillation After Circumferential Pulmonary Vein Ablation

Liu

Dong

et al. 2008

Clin Cardiol

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Background: Early recurrence of atrial fibrillation (ERAF) after catheter ablation is common and has been thoroughly studied. However, very late recurrence of atrial fibrillation (VLRAF) is rarely researched, and its characteristics have not been determined. Hypothesis: The aim of this study was to investigate the clinical characteristics of VLRAF after circumferential pulmonary vein ablation (CPVA), and to identify the risk factors for VLRAF. Methods: We retrospectively studied 259 consecutive patients with atrial fibrillation (AF) who were referred for CPVA. Clinical variables were investigated and predictors of VLRAF were identified. Results: A total of 249 patients were enrolled in this study. After a mean follow-up of 18.2±4.4 mo, 14 patients (5.6%) had VLRAF. Patients with VLRAF were more likely than those without recurrence to have ERAF (78.6% versus 17.8%, p = 0.000) and persistent AF (50.0% versus 13.0%, p = 0.000), but were less likely to achieve pulmonary vein (PV)

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Section: Vlraf After Catheter Ablationcontrasting

confidence: 39%

Section: Vlraf After Catheter Ablationmentioning

confidence: 95%

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Predictors of Very Late Recurrence of Atrial Fibrillation After Circumferential Pulmonary Vein Ablation

Liu

Dong

et al. 2008

Clin Cardiol

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“…Literature search : We searched MEDLINE, EMBASE, the Web of Science, and the Cochrane Database to identify all the studies in patients with AF using the terms "ablation", "atrial Vol 58 No 4 META-ANALYSIS OF SVI ON AF ABLATION fibrillation" and "superior vena cava". Two investigators (Li and Jiang) independently screened all titles and abstracts to identify studies for further assessment.…”

Section: Methodsmentioning

confidence: 99%

“…[3][4][5] Some researchers have investigated the efficacy of empiric SVC isolation (SVCI) in addition to conventional SVCI (performing SVCI only for patients who have triggers in the SVC) 6) in order to improve success rates and reduce recurrence rates in patients with AF. [7][8][9] However, some studies also have provided conflicting data indicating that there was no statistical significance for these two strategies after the initial AF ablation.…”

mentioning

confidence: 99%

Comparison of Empiric Isolation and Conventional Isolation of Superior Vena Cava in Addition to Pulmonary Vein Isolation on the Outcome of Paroxysmal Atrial Fibrillation Ablation

Jiang²,

Zhong

et al. 2017

Int. Heart J.

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SummaryRadiofrequency catheter ablation (RFCA) in the treatment of AF is currently based on pulmonary vein isolation (PVI). Some studies have investigated the efficacy of empiric SVC isolation (SVCI) in addition to conventional PVI in order to improve success rates and reduce recurrence rates. However, the results of the studies have given conflicting data.We performed a meta-analysis to evaluate the efficacy and safety of the empiric SVCI compared with conventional SVCI for paroxysmal atrial fibrillation (PAF) ablation.We searched MEDLINE, EMBASE, the Web of Science, and the Cochrane Database from the period January 1986 to August 2016 and identified qualified studies. The primary clinical outcome was the recurrence rate of atrial tachyarrhythmias, and the secondary clinical outcomes were procedure time, fluoroscopy time, and complications.We identified 3 randomized controlled trials (RCTs) and one nonrandomized, observational study (nROS) involving 245 patients with empiric SVCI and 269 patients with conventional SVCI. The empiric SVCI group had a lower recurrence rate of atrial tachyarrhythmia after a single procedure compared with the conventional SVCI group (16.7% versus 29.4%, OR: 0.48, 95%CI: 0.31 to 0.74, P = 0.0009). There was no significant difference in fluoroscopic time (P = 0.22), procedure time (P = 0.32), or clinical complications (P = 0.33) between the two groups.Empiric SVCI is more effective than conventional SVCI in terms of the long-term outcomes of PAF patients after a single PVI procedure, with the same fluoroscopic time, procedure time, and clinical complications. (Int Heart J 2017; 58: 500-505) Key words: Arrhythmia, Pulmonary vein, Atrial fibrillation, Meta R adiofrequency catheter ablation (RFCA) is an effective treatment option for patients with atrial fibrillation (AF). At present, RFCA in the treatment of AF is based on pulmonary vein isolation (PVI), whether it is segmental PVI or circumferential PVI.1,2) AF can be also initiated by nonpulmonary vein ectopic beats such as in the superior vena cava (SVC), coronary sinus ostium, left atrial posterior wall, crista terminalis, and ligament of Marshall.3) Despite initial positive results of the PVI strategy, RFCA that targeted the pulmonary vein alone showed a significant recurrence rate after the first procedure with the reconnection of the pulmonary vein or with the emergence of non-PV ectopic foci including the SVC.3-5) Some researchers have investigated the efficacy of empiric SVC isolation (SVCI) in addition to conventional SVCI (performing SVCI only for patients who have triggers in the SVC) 6) in order to improve success rates and reduce recurrence rates in patients with AF. 7-9) However, some studies also have provided conflicting data indicating that there was no statistical significance for these two strategies after the initial AF ablation.10,11) Therefore, we believed a meta-analysis of published data was needed to assess the efficacy of empiric isolation and conventional isolation of SVC in patients with paroxysmal AF (PAF).

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The Different Mechanisms Between Late and Very Late Recurrences of Atrial Fibrillation in Patients Undergoing a Repeated Catheter Ablation

Abstract: The right atrial foci played an important role in the very late recurrence of AF, whereas the left atrial foci (the majority were PVs) were the major origin of the late recurrence of AF after the catheter ablation of paroxysmal AF.

Cited by 76 publications

References 22 publications

Predictors of Very Late Recurrence of Atrial Fibrillation After Circumferential Pulmonary Vein Ablation

Predictors of Very Late Recurrence of Atrial Fibrillation After Circumferential Pulmonary Vein Ablation

Comparison of Empiric Isolation and Conventional Isolation of Superior Vena Cava in Addition to Pulmonary Vein Isolation on the Outcome of Paroxysmal Atrial Fibrillation Ablation

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