Universität zu Köln

Lueker, Jakob, Sultan, Arian, Sehner, Susanne, Hoffmann, Boris, Servatius, Helge ORCID: 0000-0003-2887-8707, Willems, Stephan and Steven, Daniel (2016). Use of antiarrhythmic drugs during ablation of persistent atrial fibrillation: observations from a large single-centre cohort. Heart Vessels, 31 (10). S. 1669 - 1676. NEW YORK: SPRINGER. ISSN 1615-2573

Full text not available from this repository.

Abstract

Catheter ablation of complex fractionated atrial electrograms (CFAE), also known as defragmentation ablation, may be considered for the treatment of persistent atrial fibrillation (AF) beyond pulmonary vein isolation (PVI). Concomitant antiarrhythmic drug (AAD) therapy is common, but the relevance of AAD administration and its optimal timing during ablation remain unclear. Therefore, we investigated the use and timing of AADs during defragmentation ablation and their possible implications for AF termination and ablation success in a large cohort of patients. Retrospectively, we included 200 consecutive patients (age: 61 +/- 12 years, LA diameter: 47 +/- 8 mm) with persistent AF (episode duration 47 +/- 72 weeks) who underwent de novo ablation including CFAE ablation. In all patients, PVI was performed prior to CFAE ablation. The use and timing of AADs were registered. The follow-ups consisted of Holter ECGs and clinical visits. Termination of AF was achieved in 132 patients (66 %). Intraprocedural AADs were administered in 168/200 patients (84 %) 45 +/- 27 min after completion of PVI. Amiodarone was used in the majority of the patients (160/168). The timing of AAD administration was predicted by the atrial fibrillation cycle length (AFCL). At follow-up, 88 patients (46 %) were free from atrial arrhythmia. Multivariate logistic regression analysis revealed that administration of AAD early after PVI, LA size, duration of AF history, sex and AFCL were predictors of AF termination. The administration of AAD and its timing were not predictive of outcome, and age was the sole independent predictor of AF recurrence. The administration of AAD during ablation was common in this large cohort of persistent AF patients. The choice to administer AAD therapy and the timing of the administration during ablation were influenced by AFCL, and these factors did not significantly influence the moderate single procedure success rate in this retrospective analysis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Sehner, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Servatius, Helge UNSPECIFIED orcid.org/0000-0003-2887-8707 UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-260585
DOI:	10.1007/s00380-015-0771-0
Journal or Publication Title:	Heart Vessels
Volume:	31
Number:	10
Page Range:	S. 1669 - 1676
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1615-2573
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CATHETER ABLATION; SINUS RHYTHM; FOLLOW-UP; RESTORATION; PREDICTORS; AMIODARONE; FLECAINIDE; OUTCOMES Multiple languages Cardiac & Cardiovascular Systems; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26058