Middle-term results of hybrid atrial fibrillation ablation using AtriCure system
Identifikátory výsledku
Kód výsledku v IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F17%3A00098097" target="_blank" >RIV/00216224:14110/17:00098097 - isvavai.cz</a>
Výsledek na webu
<a href="http://dx.doi.org/10.1016/j.crvasa.2017.05.004" target="_blank" >http://dx.doi.org/10.1016/j.crvasa.2017.05.004</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.crvasa.2017.05.004" target="_blank" >10.1016/j.crvasa.2017.05.004</a>
Alternativní jazyky
Jazyk výsledku
angličtina
Název v původním jazyce
Middle-term results of hybrid atrial fibrillation ablation using AtriCure system
Popis výsledku v původním jazyce
Introduction: Long-term results of catheter ablation (CA) for persistent and long-standing persistent atrial fibrillation (AF) are disappointing. The hybrid approach is currently one of options for overcoming the limitations of CA. Aim: To evaluate the safety and medium-term efficacy of the hybrid approach in patients with persistent and long-standing persistent AF. Methods: All patients underwent epicardial thoracoscopic radiofrequency (RF) pulmonary vein (PV) isolation using the AtriCure clamp followed by left atrial (LA) linear lesions (using a linear pen), Marshall ligament disruption, and LA appendage exclusion using an Atriclip. All patients underwent an electrophysiological study (EPS) and RF CA 2-3 months after the initial surgery to eliminate recurrent conductions from/to the PVs or across the linear lesions, and to eliminate all spontaneous and inducible atrial arrhythmias. 7-Day ECG Holter monitoring was performed every 3 months during the first year and every 6 months afterwards to evaluate possible recurrent arrhythmias. Results: Seventy patients (49 male, median 63.5 years) took part in the study. EPS was performed 87 days (median) after the thoracoscopic surgery. Seventy-six percent of patients were in normal sinus rhythm (SR) at the start of the EPS, 7% had typical atrial flutter, 11% had atrial tachycardia, and 6% were in AF. After completion of the hybrid approach, all PVs were isolated, while a complete conduction block across the linear lines was achieved in 88.6% of patients. Twelve months after the procedure, 77.1% of patients had a stable SR without any anti-arrhythmic medication or re-ablation. If we included those on anti-arrhythmic drugs and re-ablation procedures, SR was achieved in 96.5% of patients during follow-up (936 +/- 432 days). Conclusion: The sequential hybrid approach is probably the most effective and relatively safe invasive treatment for persistent and long-term persistent AF with very low medium- to long-term recurrences. Introduction of the hybrid approach to clinical practice requires extensive cooperation between cardiologic and cardiothoracic teams. (C) 2017 The Czech Society of Cardiology. Published by Elsevier Sp. zo.o. All rights reserved.
Název v anglickém jazyce
Middle-term results of hybrid atrial fibrillation ablation using AtriCure system
Popis výsledku anglicky
Introduction: Long-term results of catheter ablation (CA) for persistent and long-standing persistent atrial fibrillation (AF) are disappointing. The hybrid approach is currently one of options for overcoming the limitations of CA. Aim: To evaluate the safety and medium-term efficacy of the hybrid approach in patients with persistent and long-standing persistent AF. Methods: All patients underwent epicardial thoracoscopic radiofrequency (RF) pulmonary vein (PV) isolation using the AtriCure clamp followed by left atrial (LA) linear lesions (using a linear pen), Marshall ligament disruption, and LA appendage exclusion using an Atriclip. All patients underwent an electrophysiological study (EPS) and RF CA 2-3 months after the initial surgery to eliminate recurrent conductions from/to the PVs or across the linear lesions, and to eliminate all spontaneous and inducible atrial arrhythmias. 7-Day ECG Holter monitoring was performed every 3 months during the first year and every 6 months afterwards to evaluate possible recurrent arrhythmias. Results: Seventy patients (49 male, median 63.5 years) took part in the study. EPS was performed 87 days (median) after the thoracoscopic surgery. Seventy-six percent of patients were in normal sinus rhythm (SR) at the start of the EPS, 7% had typical atrial flutter, 11% had atrial tachycardia, and 6% were in AF. After completion of the hybrid approach, all PVs were isolated, while a complete conduction block across the linear lines was achieved in 88.6% of patients. Twelve months after the procedure, 77.1% of patients had a stable SR without any anti-arrhythmic medication or re-ablation. If we included those on anti-arrhythmic drugs and re-ablation procedures, SR was achieved in 96.5% of patients during follow-up (936 +/- 432 days). Conclusion: The sequential hybrid approach is probably the most effective and relatively safe invasive treatment for persistent and long-term persistent AF with very low medium- to long-term recurrences. Introduction of the hybrid approach to clinical practice requires extensive cooperation between cardiologic and cardiothoracic teams. (C) 2017 The Czech Society of Cardiology. Published by Elsevier Sp. zo.o. All rights reserved.
Klasifikace
Druh
J<sub>imp</sub> - Článek v periodiku v databázi Web of Science
CEP obor
—
OECD FORD obor
30201 - Cardiac and Cardiovascular systems
Návaznosti výsledku
Projekt
—
Návaznosti
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Ostatní
Rok uplatnění
2017
Kód důvěrnosti údajů
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Údaje specifické pro druh výsledku
Název periodika
Cor et Vasa
ISSN
0010-8650
e-ISSN
—
Svazek periodika
59
Číslo periodika v rámci svazku
4
Stát vydavatele periodika
NL - Nizozemsko
Počet stran výsledku
8
Strana od-do
„E345“-„E352“
Kód UT WoS článku
000410033600011
EID výsledku v databázi Scopus
2-s2.0-85020176511