Impact of Non‐Pulmonary Vein Foci on the Outcome of the Second Session of Catheter Ablation for Paroxysmal Atrial Fibrillation

Masateru Takigawa; Atsushi TAKAHASHI; Taishi Kuwahara; Kenji Okubo; Yoshihide Takahashi; Emiko Nakashima; Yuji Watari; Kazuya Yamao; Jun Nakajima; Katsumasa Takagi; SHIGEKI KIMURA; Hiroyuki Hikita; Kenzo Hirao; Mitsuaki Isobe

doi:10.1111/jce.12681

journal article May 25, 2015

Impact of Non‐Pulmonary Vein Foci on the Outcome of the Second Session of Catheter Ablation for Paroxysmal Atrial Fibrillation

Masateru Takigawa

Atsushi TAKAHASHI

Taishi Kuwahara Kenji Okubo

Yoshihide Takahashi Emiko Nakashima Yuji Watari Kazuya Yamao Jun Nakajima

Katsumasa Takagi SHIGEKI KIMURA Hiroyuki Hikita Kenzo Hirao Mitsuaki Isobe

Journal of Cardiovascular Electrophysiology Vol. 26 No. 7 pp. 739-746 · Wiley

View at Publisher Save 10.1111/jce.12681

Abstract

Impact of Non‐PV AF Foci on the Second Catheter Ablation for PAFBackgroundParoxysmal atrial fibrillation (AF) is primarily triggered by pulmonary veins (PVs). However, non‐PV AF foci may also trigger AF.MethodsWe examined 207 patients (mean age, 62 ± 11 years; 166 men) who underwent a second catheter ablation (CA) and evaluated the clinical significance of non‐PV AF foci on the outcomes.ResultsElectrical reconnections between the PVs and left atrium (LA) were observed in 162 patients (78.3%). Non‐PV AF foci were identified in 95 patients (45.9%, 60 patients with successfully ablated non‐PV AF foci and 35 with unmappable non‐PV AF foci). During a median follow‐up period of 22.7 months, 61 patients (29.5%; 18/112 [16.1%] without non‐PV AF foci vs. 20/60 [33.3%] with successfully ablated non‐PV AF foci vs. 23/35 [65.7%] with unmappable non‐PV AF foci, P < 0.0001) developed AF recurrence; 52 (85.2%) developed recurrence within 1 year. The presence of non‐PV AF foci was a significant clinical predictor of AF recurrence after the second CA; successfully ablated non‐PV AF foci increased the AF recurrence risk by 2.24 times (95% confidence interval [CI], 1.12–4.54; P = 0.02), and unmappable AF foci increased this risk by 5.58 times (95% CI, 2.73–11.63; P < 0.0001).ConclusionNearly half of the patients had non‐PV AF foci at the second CA session. AF recurred after the second CA session in approximately 30%, with most recurrences happening within 1 year. The presence of non‐PV AF foci significantly increased the AF recurrence risk after a second CA. When non‐PV AF foci were unmappable, the AF recurrence rate was extremely high.

Topics

No keywords indexed for this article. Browse by subject →

References

23

[1]

Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins

Michel Haissaguerre, Pierre Jais, Dipen C. Shah et al.

New England Journal of Medicine 10.1056/nejm199809033391003

[2]

10.1111/j.1540-8167.2007.01071.x

[3]

10.1161/01.cir.0000074206.52056.2d

[4]

10.1161/circulationaha.110.946806

[5]

10.1016/j.ahj.2011.04.013

[6]

10.1161/jaha.112.004549

[7]

10.1093/europace/eun018

[8]

10.1111/j.1540-8167.2010.01885.x

[9]

10.1161/circep.113.000471

[10]

European Heart Rhythm Association (EHRA); European Cardiac Arrhythmia Scoiety (ECAS); American College of Cardiology (ACC); American Heart Association (AHA); Society of Thoracic Surgeons (STS) "HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: Recommendations for personnel, policy, procedures and follow‐up. A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation" Heart Rhythm (2007) 10.1016/j.hrthm.2007.04.005

[11]

10.1111/j.1540-8167.2006.00753.x

[12]

10.1161/01.cir.0000033115.92612.f4

[13]

10.1016/j.hrthm.2010.05.017

[14]

10.1046/j.1540-8167.2004.04524.x

[15]

10.1161/circulationaha.105.541052

[16]

10.1046/j.1540-8167.2003.03013.x

[17]

10.1016/j.hrthm.2006.05.007

[18]

10.1046/j.1460-9592.2003.t01-1-00243.x

[19]

10.1016/j.athoracsur.2006.09.022

[20]

10.1016/j.hrthm.2010.12.047

[21]

10.1016/j.jacc.2003.12.054

[22]

10.1016/j.jjcc.2009.11.002

[23]

10.1016/j.jacc.2012.05.022

Cited By

83

Presence of non-pulmonary vein foci in patients with atrial fibrillation undergoing standard ablation of pulmonary vein isolation: Clinical characteristics and long-term ablation outcome

Yukihiro Inamura, Junichi Nitta · 2021

IJC Heart & Vasculature

Metrics

83

Citations

23

References

Details

Published: May 25, 2015
Vol/Issue: 26(7)
Pages: 739-746
License: View

Authors

M

Masateru Takigawa

Cardiovascular Center Yokosuka Kyosai Hospital Yokosuka Japan; Heart Rhythm Center Tokyo Medical and Dental University Tokyo Japan; Department of Cardiovascular Medicine Tokyo Medical and Dental University Tokyo Japan

A

Atsushi TAKAHASHI