Catheter ablation (CA) of atrial fibrillation (AF) triggers, including non-pulmonary vein (PV) foci, contributes to improved procedural outcomes. However, the clinical significance of an AF trigger ablation during second CA procedures for nonparoxysmal AF is unknown. We enrolled 94 patients with nonparoxysmal AF undergoing a second CA. Intracardiac cardioversion during AF using high-dose isoproterenol was performed to determine the presence or absence of AF triggers. PV re-isolations were performed if PV potentials recurred, and if AF triggers appeared from any non-PV sites, additional ablation was added to those sites. We investigated the incidence of atrial arrhythmia recurrence (AAR) >3 months post-CA. Of the 94 enrolled patients, AF triggers were identified in 65 (69.1%), and of those with AF triggers, successful elimination of the triggers was achieved in 47 patients (72.3%). Multivariate analysis revealed that no observed AF triggers were a significant predictor of AAR (hazard ratio [HR] 1.97, 95% confidence interval [CI] 1.21-3.46, P=0.019). In a subanalysis of the patients with AF triggers, multivariate analysis showed that unsuccessful trigger ablation was significantly associated with AAR (HR 5.84, 95% CI 2.79-12.22, P<0.01). Having no observed AF triggers during a second CA session significantly increased the risk of AAR, as did unsuccessful CA of AF triggers.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10920014 | PMC |
| http://dx.doi.org/10.1253/circrep.CR-23-0069 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation.
N Engl J Med
January 2025
From the TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston (C.T.R., S.M.P., R.P.G., D.A.M., J.F.K., E.L.G., S.A.M., S.D.W., M.S.S.); Anthos Therapeutics, Cambridge, MA (B.H., S.P., D.B.); the Heart Rhythm Center, Taipei Veterans General Hospital and Cardiovascular Center, Taipei, Taiwan (S.-A.C.); Taichung Veterans Hospital, Taichung, Taiwan (S.-A.C.); National Yang Ming Chiao Tung University, Hsinchu, Taiwan (S.-A.C.); National Chung Hsing University, Taichung, Taiwan (S.-A.C.); St. Michael's Hospital, Unity Health Toronto, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto (S.G.G.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (S.G.G.); the Division of Cardiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (B.J.); the Department of Cardiology, Central Hospital of Northern Pest-Military Hospital, Budapest, Hungary (R.G.K.); the Heart and Vascular Center, Semmelweis University, Budapest, Hungary (R.G.K.); the Internal Cardiology Department, St. Ann University Hospital and Masaryk University, Brno, Czech Republic (J.S.); the Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W.W.); the Departments of Medicine and of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada (J.W.); and the Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada (J.W.).
Background: Abelacimab is a fully human monoclonal antibody that binds to the inactive form of factor XI and blocks its activation. The safety of abelacimab as compared with a direct oral anticoagulant in patients with atrial fibrillation is unknown.
Methods: Patients with atrial fibrillation and a moderate-to-high risk of stroke were randomly assigned, in a 1:1:1 ratio, to receive subcutaneous injection of abelacimab (150 mg or 90 mg once monthly) administered in a blinded fashion or oral rivaroxaban (20 mg once daily) administered in an open-label fashion.
Diagnosis of atrial cardiomyopathy: from the electrocardiogram to the new opportunities with multimodality imaging.
J Cardiovasc Med (Hagerstown)
February 2025
Division of Cardiology, Department of Systems Medicine, Tor Vergata University, Rome.
Atrial cardiomyopathy (AC) has been defined by the European Heart Rhythm Association as "Any complex of structural, architectural, contractile, or electrophysiologic changes in the atria with the potential to produce clinically relevant manifestations".1 The left atrium (LA) plays a key role in maintaining normal cardiac function; in fact atrial dysfunction has emerged as an essential determinant of outcomes in different clinical scenarios, such as valvular diseases, heart failure (HF), coronary artery disease (CAD) and atrial fibrillation (AF). A comprehensive evaluation, both anatomical and functional, is routinely performed in cardiac imaging laboratories.
View Article and Find Full Text PDFComparative safety and effectiveness of oral anticoagulants in key subgroups of patients with non-valvular atrial fibrillation and at high risk of gastrointestinal bleeding: A cohort study based on the French National Health Data System (SNDS).
PLoS One
January 2025
Pfizer Ltd., Tadworth, United Kingdom.
Background: Risk factors and comorbidities can complicate management of non-valvular atrial fibrillation. We describe and compare real-world safety and effectiveness of direct oral anticoagulants (DOACs; apixaban, rivaroxaban, dabigatran) and vitamin K antagonists (VKAs) in subgroups of patients with non-valvular atrial fibrillation at high risk for gastrointestinal (GI) bleeding, utilizing data from a national quasi-exhaustive French database.
Methods: Anticoagulant-naïve adults with non-valvular atrial fibrillation with ≥1 gastrointestinal bleeding risk factor, initiating anticoagulant treatment January 2016-December 2019, and covered by the French national health data system were eligible.
Ventricular-Arterial Coupling: Changes with aging and implications across cardiovascular conditions.
Blood Press
January 2025
Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Kraków, Poland.
Purpose: Ventricular-arterial coupling (VAC) is a crucial concept in cardiovascular physiology, representing the dynamic interaction between the left ventricle and the arterial system. This comprehensive literature review explores the changes in VAC with aging and various cardiovascular diseases (CVDs).
Materials And Methods: This literature review covers studies on changes in VAC with age and common CVDs such as arterial hypertension, atrial fibrillation, heart failure with preserved and reduced ejection fraction and aortic stenosis.
Family Screening in Patients With Dilated and Arrhythmogenic Cardiomyopathy: The Road Toward Gene-Specific Recommendations.
Circ Genom Precis Med
January 2025
Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University, the Netherlands (S.L.V.M.S., N.J.B., M.F.G.H.M.V., V.P.M.v.E., J.A.J.V.).
Want 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!