Pulmonary Vein Isolation Alone Versus Additional Linear Ablation in Patients with Persistent Atrial Fibrillation Converted to Paroxysmal Type with Antiarrhythmic Drug Therapy: A Multicenter, Prospective, Randomized Study

Hee Tae Yu, Jaemin Shim, Junbeom Park, In Soo Kim, Tae Hoon Kim, Jae Sun Uhm, Boyoung Joung, Moon Hyoung Lee, Young Hoon Kim, Hui Nam Pak

    Research output: Contribution to journalArticlepeer-review

    20 Citations (Scopus)

    Abstract

    Background - Atrial fibrillation (AF) type can vary depending on condition and timing, and some patients who initially present with persistent AF may be changed to paroxysmal AF after antiarrhythmic drug medication and cardioversion. We investigated whether circumferential pulmonary vein isolation (CPVI) alone is an effective rhythm control strategy in patients with persistent AF to paroxysmal AF. Methods and Results - We enrolled 113 patients with persistent AF to paroxysmal AF (male 75%, 60.4±10.1 years old) who underwent catheter ablation for nonvalvular AF at 3 tertiary hospitals. The participants were randomly assigned to 2 groups: CPVI alone (n=59) or CPVI plus linear ablation (CPVI+Line; posterior box+anterior line, n=54). Compared with the CPVI+Line, CPVI alone required shorter procedure (187.2±58.0 versus 211.2±63.9 min; P=0.043) and ablation times (4922.1±1110.5 versus 6205.7±1425.2 s; P<0.001) without difference in procedure-related major complication (3% versus 2%; P=0.611). Antiarrhythmic drug utility rates after ablation were not different between the 2 groups (22% versus 30%; P=0.356). Overall, AF-free survival (log-rank; P=0.206) and AF and antiarrhythmic drug-free survival (log-rank; P=0.321) were not different between groups. Conclusions - CPVI alone is an effective rhythm control strategy with a shorter procedure time in persistent AF patients converted to paroxysmal AF compared with CPVI with linear ablation.

    Original languageEnglish
    Article numbere004915
    JournalCirculation: Arrhythmia and Electrophysiology
    Volume10
    Issue number6
    DOIs
    Publication statusPublished - 2017 Jun 1

    Keywords

    • antiarrhythmic drug
    • atrial fibrillation
    • catheter ablation
    • persistent atrial fibrillation
    • recurrent event

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

    Fingerprint

    Dive into the research topics of 'Pulmonary Vein Isolation Alone Versus Additional Linear Ablation in Patients with Persistent Atrial Fibrillation Converted to Paroxysmal Type with Antiarrhythmic Drug Therapy: A Multicenter, Prospective, Randomized Study'. Together they form a unique fingerprint.

    Cite this