Approaches to Catheter Ablation for Persistent Atrial Fibrillation

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Articulo sobre ablación auricular

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Approaches to Catheter Ablation for Persistent Atrial Fibrillation
  1. APPROACHES
    1. Ablation with pulmonary-vein isolation alone
      1. Pulmonary-vein isolation plus ablation of complex fractionated electrograms
        1. Pulmonary-vein isoation plus linear ablation
        2. CRITERIA
          1. INCLUSION
            1. Older than 18 yars old
              1. They should have symptomatic persistent atrial fibrilation
                1. They have to be undergoing ablation for the first time
                  1. All participating patients provided written informed consent
                  2. EXCLUSION
                    1. Paroxysmal atrial fibrilation
                      1. Sustained atrial fibrilation lasting more than 3 years
                        1. Left atrial diameter of 60mm or greater
                        2. PATIENTS WERE RANDOMLY ASSIGNED
                          1. IN THIS WAY
                            1. Pulmonary-vein isolation alone
                              1. Pulmonary-vein isolation plus ablation of compex fractionated electrograms
                                1. Pulmonary-vein isolation plus linear ablation across the roof of the left atrium and in the mitrial valve ithmus
                                  1. POCEDURES
                                    1. It was used radio diofrequency energy delivered by a catheter with an open, irrigated tip
                                      1. Antigulation was continued after ablation for a minimum of 3 months
                                        1. Before ablation, tratment with antiarrhythmic medications was stopped and patients recived oral anticoagulation for at least 4 weeks
                                        2. CLINICAL ASSESTENTS
                                          1. EKG 12 lead
                                            1. Holter-monitor
                                              1. Trans-telephonic monitor
                                              2. STUDY OUTCOMES
                                                1. freedom from any documented episode of atrial fibrillation lasting longer than 30 seconds and occurring after the performance of a single ablation procedure
                                                  1. Main secondary outcomes included freedom from documented atrial fibrillation after two ablation procedures
                                                    1. The expected freedom from atrial fibrillation after one ablation procedure was 75% for isolation plus electrograms and 45% for isolation alone.
                                                      1. Successful pulmonary-vein isolation was achieved in 97% of all patients, with no significant differences between groups.
                                                      2. Adverse Events
                                                        1. The most common adverse events were sedation-related complications
                                                          1. Arteriovenous fistula or pseudoaneurysm at the access site
                                                            1. Hematoma at the access site
                                                              1. Fluid overload
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