In:
Journal of Cardiovascular Electrophysiology, Wiley, Vol. 32, No. 7 ( 2021-07), p. 1833-1841
Abstract:
The impact of basic atrial rhythm (sinus rhythm [SR] vs. atrial fibrillation [AF] ) during AF ablation on efficacy and safety is unknown. Methods About 3375 patients from the German Ablation Registry undergoing first‐time AF ablation were divided according to the type of AF and the basic atrial rhythm during the ablation procedure: paroxysmal AF (PAF) and SR [group Ia], PAF and AF [group Ib] ), persistent AF and SR (IIa), and persistent AF and AF (IIb). Results Patients in SR ( n = 2312 [67%]) underwent cryoballoon ablation more often (Ia vs. Ib p = .002 and IIa vs. IIb p = .010, whereas in patients in AF ( n = 1063 [33%]) radiofrequency (RF)‐based ablation (Ia vs. Ib p = .006 and IIa vs. IIb p = .014) including left and/or right atrial substrate modification was more frequently performed. Depending on the basic rhythm there was no difference regarding arrhythmia recurrence during long‐term follow‐up. For patients suffering from persistent AF acute procedure‐related complications were more often documented when ablated in AF (9.1% vs. 4.6%, p = .012). which was mainly driven by the higher occurrence of pericardial effusion/tamponade. For patients suffering from persistent AF, favorable results were found regarding 366‐day Kaplan–Meier estimates of the incidence of MACCE (death, myocardial infarction, and stroke; p = .011) and the composite endpoint of death, myocardial infarction, stroke, and major bleeding ( p = .006), when ablated in SR. Conclusion Basic atrial rhythm at the time of AF ablation did not affect long‐term rhythm outcome. For patients suffering from persistent AF a more favorable acute and long‐term safety profile was observed when ablated in SR.
Type of Medium:
Online Resource
ISSN:
1045-3873
,
1540-8167
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2037519-0
