Universität zu Köln

Sultan, Arian, Lueker, Jakob, Hoffmann, Boris, Servatius, Helge ORCID: 0000-0003-2887-8707, Schaeffer, Benjamin, Steven, Daniel and Willems, Stephan (2016). Interventional management of recurrent paroxysmal atrial fibrillation despite isolated pulmonary veins: impact of an ablation strategy targeting inducible atrial tachyarrhythmias. Europace, 18 (7). S. 994 - 1000. OXFORD: OXFORD UNIV PRESS. ISSN 1532-2092

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Abstract

Aims Pulmonary vein isolation (PVI) is an effective treatment option for paroxysmal atrial fibrillation (PAF). Reconnection of pulmonary veins (PVs) is the predominant cause for recurrence of PAF. However, treatment of patients with recurrence of PAF despite isolated PV in the absence of extra-PV foci remains challenging. Methods and results Of 265 patients undergoing repeat catheter ablation (CA) for recurrence of PAF 21 (8%) patients (14 men, age 58 +/- 14 years) showed no reconnection of PV. Therefore, inducibility of sustained atrial arrhythmias was tested. If sustained atrial fibrillation (AF) or sustained atrial tachycardia (AT) was induced, patients underwent CA. During follow-up (FU), Holter-and Tele-electrocardiogram were performed. In 19 (91%) of 21 patients, sustained atrial arrhythmias [16 (84%) AF; 3 (15%) patients AT] were induced. One patient showed PAF. Eighteen patients underwent CA aiming for termination of induced arrhythmia. In 14 (77%) patients, termination into sinus rhythm was achieved. Despite extensive CA, three (16%) patients were externally cardioverted. No periprocedural complications occurred. During 21.2 +/- 6.8-month FU, 10 (53%) patients were free of any arrhythmia. Paroxysmal atrial fibrillation recurred in 4 (21%) and AT in 5 (26%) patients. One patient showed persistent AF. Repeat CA was scheduled and successfully performed for these patients. Conclusion In patients with recurrence of PAF despite isolated PV, termination of induced atrial arrhythmias can be achieved in most patients by defragmentation and AT ablation. Moreover, this ablation strategy results in favourable mid-term outcome results.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Servatius, Helge UNSPECIFIED orcid.org/0000-0003-2887-8707 UNSPECIFIED Schaeffer, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-270326
DOI:	10.1093/europace/euv332
Journal or Publication Title:	Europace
Volume:	18
Number:	7
Page Range:	S. 994 - 1000
Date:	2016
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1532-2092
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CATHETER ABLATION; ADENOSINE-TRIPHOSPHATE; FRACTIONATED ELECTROGRAMS; CLINICAL-SIGNIFICANCE; SUBSTRATE ABLATION; MECHANISMS; TACHYCARDIA; CONDUCTION; AF; TERMINATION Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27032