Universität zu Köln

Dinshaw, Leon, Schaeffer, Benjamin, Akbulak, Oezgg, Jularic, Mario, Hartmann, Jens, Klatt, Niklas, Dickow, Jannis, Gunawardene, Melanie, Muenkler, Paula, Hakmi, Samer, Pecha, Simon, Sultan, Arian, Lueker, Jakob, Pinnschmidt, Hans, Hoffmann, Boris, Gosau, Nils, Eickholt, Christian ORCID: 0000-0002-5458-9688, Willems, Stephan, Steven, Daniel and Meyer, Christian (2019). Long-term efficacy and safety of radiofrequency catheter ablation of atrial fibrillation in patients with cardiac implantable electronic devices and transvenous leads. J. Cardiovasc. Electrophysiol., 30 (5). S. 679 - 688. HOBOKEN: WILEY. ISSN 1540-8167

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Abstract

Introduction Long-term efficacy and safety are uncertain in patients with cardiac implantable electronic devices (CIED) and transvenous leads (TVL) undergoing radiofrequency catheter ablation of atrial fibrillation (AF). Thus, we assessed the outcome of AF ablation in those patients during long-term follow-up using continuous atrial rhythm monitoring (CARM). Methods and Results A total of 190 patients (71.3 +/- 10.7 years; 108 (56.8% men) were included in this study. At index procedure 81 (42.6%) patients presented with paroxysmal AF and 109 (57.4%) with persistent AF. The ablation strategy included pulmonary vein isolation in all patients and biatrial ablation of complex fractionated electrograms with additional ablation lines, if appropriate. AF recurrences were assessed by CARM- and CIED-related complications by device follow-up. After a mean follow-up of 55.4 +/- 38.1 months, freedom of AF was found in 86 (61.4%) and clinical success defined as an AF burden less than or equal to 1% in 101 (72.1%) patients. Freedom of AF was reported in 74.6% and 51.9% (P = 0.006) and clinical success in 89.8% and 59.3% (P < 0.001) of patients with paroxysmal and persistent AF, respectively. In 3 of 408 (0.7%) ablation procedures, a TVL malfunction occurred within 90 days after catheter ablation. During long-term follow-up 9 (4.7%) patients showed lead dislodgement, 2 (1.1%) lead fracture, and 2 (1.1%) lead insulation defect not related to the ablation procedure. Conclusion Our findings using CARM demonstrate long-term efficacy and safety of radiofrequency catheter ablation of AF in patients with CIED and TVL.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dinshaw, Leon UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaeffer, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Akbulak, Oezgg UNSPECIFIED UNSPECIFIED UNSPECIFIED Jularic, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Klatt, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Dickow, Jannis UNSPECIFIED UNSPECIFIED UNSPECIFIED Gunawardene, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Muenkler, Paula UNSPECIFIED UNSPECIFIED UNSPECIFIED Hakmi, Samer UNSPECIFIED UNSPECIFIED UNSPECIFIED Pecha, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Pinnschmidt, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Gosau, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Eickholt, Christian UNSPECIFIED orcid.org/0000-0002-5458-9688 UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-149004
DOI:	10.1111/jce.13890
Journal or Publication Title:	J. Cardiovasc. Electrophysiol.
Volume:	30
Number:	5
Page Range:	S. 679 - 688
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1540-8167
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARDIOVERTER-DEFIBRILLATORS; MAPPING SYSTEM; FOLLOW-UP; THERAPY; PACEMAKER; BURDEN; ALGORITHMS; INSIGHTS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14900