AI Article Synopsis
Article Abstract
Background: Clinical outcomes after ablation of persistent atrial fibrillation remain suboptimal. Identification of AF drivers using a novel integrated mapping technique may be crucial to ameliorate the clinical outcome.
Methods And Results: Persistent AF patients were prospectively enrolled to undergo high-density electrophysiological mapping to identify repetitive-regular activities (RRas) before modified circumferential pulmonary vein (PV) ablation. They have been randomly assigned (1:1 ratio) to ablation of RRa followed by modified circumferential PV ablation (mapping group; n=41) or modified circumferential PV ablation alone (control group; n=40). The primary end point was freedom from arrhythmic recurrences at 1 year. In total, 81 persistent AF patients (74% male; mean age, 61.7±10.6 years) underwent mapping/ablation procedure. The regions exhibiting RRa were 479 in 81 patients (5.9±2.4 RRa per patient): 232 regions in the mapping group (n=41) and 247 in the control group (n=40). Overall, 185 of 479 (39%) RRas were identified within the PVs, whereas 294 of 479 (61%) in non-PV regions. Mapping-guided ablation resulted in higher arrhythmia termination rate when compared with conventional strategy (25/41, 61% versus 12/40, 30%; <0.007). Total radiofrequency duration (=0.38), mapping (=0.46), and fluoroscopy times (=0.69) were not significantly different between the groups. No major procedure-related adverse events occurred. After 1 year, 73.2% of mapping group patients were free from recurrences versus 50% of control group (=0.03).
Conclusions: Targeted ablation of regions showing RRa provided an adjunctive benefit in terms of arrhythmia freedom at 1-year follow-up in the treatment of persistent AF. These findings might support a patient-tailored strategy in subjects with nonparoxysmal AF and should be confirmed by additional larger, randomized, multicenter studies.
Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier NCT02571218.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/CIRCEP.117.005904 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Failed labral reconstruction of the hip can be successfully revised to another labral reconstruction: improved patient-reported outcomes at a minimum of 2-year follow-up.
J Hip Preserv Surg
December 2024
Rock Harbor Research Institute, Key Largo, FL 33037, United States.
The purpose of this study was to validate the success of revision arthroscopic circumferential allograft labral reconstruction (CLR) in nonarthritic hips, which, in the rare case of failure, had previously undergone labral reconstruction by the same surgeon. Using a minimum of 24-month follow-up, data from 24 hips having undergone revision CLR were analyzed to determine improvements in patient-reported outcomes (PROs). All included cases completed a minimum of 24 months follow-up, with a success rate of 96%.
View Article and Find Full Text PDFDevelopment of Electrospinning Setup for Vascular Tissue-Engineering Application with Thick-Hierarchical Fiber Alignment.
Tissue Eng Regen Med
January 2025
College of Materials Science and Engineering, Hunan University, Changsha, 410072, People's Republic of China.
Background: Tissue engineering holds promise for vascular repair and regeneration by mimicking the extracellular matrix of blood vessels. However, achieving a functional and thick vascular wall with aligned fiber architecture by electrospinning remains a significant challenge.
Methods: A novel electrospinning setup was developed that utilizes an auxiliary electrode and a spring.
Challenges in detecting various peri-implant bone defects on modified intraoral oblique radiographic projections: evaluation of an artificial mandibular model.
Oral Radiol
January 2025
Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry, Tokyo, Japan.
Objective: The objective of this study was to evaluate the effectiveness of oblique radiographic projection using the intraoral paralleling technique in detecting various peri-implant bone defects.
Methods: Artificial mandibular models with appropriate radiopacity were created. An alveolar bone model without bone defects and models with 12 types of peri-implant bone defects (buccal, circumferential, and mixed types with different widths and depths) were created.
Circumferential nerve wrapping with muscle autograft: a modified strategy of microvascular decompression for trigeminal neuralgia.
Neurosurg Rev
January 2025
Department of Neurosurgery, IRCCS Neuromed, Via Atinense 18, Pozzilli, IS, 86077, Italy.
Microvascular decompression is considered a first-line treatment in classical trigeminal neuralgia. Teflon is the material commonly used. The use of autologous muscle has been occasionally reported.
View Article and Find Full Text PDFComplex perianal abscess: a case report of shooting from the hip.
J Surg Case Rep
January 2025
Department of General Surgery, Cairns Hospital, 165 The Esplanade, Cairns 4870, Australia.
The perianal abscess is a common emergency surgical presentation. While in most cases simple drainage suffices, occasionally the abscess can track deeply presenting a management challenge. We describe the case of a complex circumferential horseshoe ischioanal abscess with extension below the levator ani through the greater sciatic notch and into the left gluteal region, with the collection involving the intergluteal space and gluteus maximus.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!