| Author/Editor | Geršak, Borut; Kiser, Andy C; Bartus, Krzyszof; Sadowski, Jerzy; Harringer, Wolfgang; Knaut, Michael; Wimmer-Greinecker, Gerhard; Pernat, Andrej | |
| Title | Importance of evaluating conduction block in radiofrequency ablation for atrial fibrillation | |
| Type | članek | |
| Source | Eur J Cardiothorac Surg | |
| Vol. and No. | Letnik 41, št. 1 | |
| Publication year | 2012 | |
| Volume | str. 113-8 | |
| Language | eng | |
| Abstract | Objective: Atrial fibrillation (AF) is the most frequently diagnosed cardiac arrhythmia. Anti-arrhythmic drugs may be used to suppress ectopic foci and interrupt reentry circuits, but are often insufficient to treat recurrent AF and have a number of adverse effects. Alternative therapies, such as catheter and surgical ablation, have been explored. This investigation examines the importance of assessing exit block when performing surgical ablation during beating-heart treatment of AF. Methods: This was an evaluation of pooled data from multicenter prospective results obtained in AF patients who received ablation with a new, irrigated, vacuum-integrated device that creates linear lesions during beating-heart/open-chest or minimally invasive, port-access procedures. Electrocardiogram or Holter data were collected intra-operatively and at 1, 3, 6, and 12 months. Outcomes were also evaluated for patients who were or 'were not' tested for exit block following the ablation procedure. Results: A total of 93 patients were treated (61 open-chest surgeries, 32 port-access procedures). There were no device-related complications and no operative mortality. At 341 days' average follow-up, 71/86 (83%) patients were free from AF, 66/86 (77%) were in sinus rhythm, and 60/86 (70%) were free from AF and off Class I and III anti-arrhythmic drugs (AADs). At 12 months, 23/23 (100%) patients with exit block confirmed were AF free compared with 13/21 (62%) patients with exit block not tested (p</=0.01, Fisher's exact test); 20/23 (87%) were in sinus rhythm compared with 12/21 (57%) patients with exit block not tested (p</=0.05, Fisher's exact test); and 20/23 (87%) were AF free without Class I and III AADs compared with 10/21 (48%) patients with exit block not tested (p</=0.01, Fisher's exact test). Both open-chest and port-access procedures yielded decreases in left-atrial size from baseline to 6 months' follow-up. (Abs. trunc. at 2000 ch.) | |
| Descriptors | ATRIAL FIBRILLATION CATHETER ABLATION HEART BLOCK ANTI-ARRHYTHMIA AGENTS TREATMENT OUTCOME MULTICENTER STUDIES |