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Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study.
Benali, Karim; Barré, Valentin; Hermida, Alexis; Galand, Vincent; Milhem, Antoine; Philibert, Séverine; Boveda, Serge; Bars, Clément; Anselme, Frédéric; Maille, Baptiste; André, Clémentine; Behaghel, Albin; Moubarak, Ghassan; Clémenty, Nicolas; Da Costa, Antoine; Arnaud, Marine; Venier, Sandrine; Sebag, Frédéric; Jésel-Morel, Laurence; Sagnard, Audrey; Champ-Rigot, Laure; Dang, Duc; Guy-Moyat, Benoit; Abbey, Selim; Garcia, Rodrigue; Césari, Olivier; Badenco, Nicolas; Lepillier, Antoine; Ninni, Sandro; Boulé, Stéphane; Maury, Philippe; Algalarrondo, Vincent; Bakouboula, Babé; Mansourati, Jacques; Lesaffre, François; Lagrange, Philippe; Bouzeman, Abdeslam; Muresan, Lucian; Bacquelin, Raoul; Bortone, Agustin; Bun, Sok-Sithikun; Pavin, Dominique; Macle, Laurent; Martins, Raphaël P.
Afiliación
  • Benali K; CHU Saint Etienne, University of Rennes, INSERM, LTSI -UMR 1099, Rennes (K.B.).
  • Barré V; University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.).
  • Hermida A; CHU d'Amiens, Amiens (A.H.).
  • Galand V; University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.).
  • Milhem A; CH La Rochelle (A.M.).
  • Philibert S; Hôpital Européen Georges Pompidou, Paris (S.P.).
  • Boveda S; Cardiology-Heart Rhythm Management Department, Clinique Pasteur, Toulouse (S.B.).
  • Bars C; Clinique Saint-Joseph, Marseille (C.B.).
  • Anselme F; CHU Rouen, Rouen (F.A.).
  • Maille B; CHU Marseille (B.M.).
  • André C; CHU Bordeaux (C.A.).
  • Behaghel A; Clinique Saint-Joseph, Trelazé (A.B.).
  • Moubarak G; Clinique Ambroise Paré, Neuilly-Sur-Seine, Paris (G.M.).
  • Clémenty N; CHU Tours (N.C.).
  • Da Costa A; CHU Saint Etienne (A.D.C.).
  • Arnaud M; CHU Nantes (M.A.).
  • Venier S; CHU Grenoble (S.V.).
  • Sebag F; Rythmologie, Institut Mutualiste Montsouris, Paris (F.S.).
  • Jésel-Morel L; CHU Strasbourg (L.J.-M.).
  • Sagnard A; CHU Dijon (A.S.).
  • Champ-Rigot L; CHU Caen (L.C.-R.).
  • Dang D; CH Aix-en-Provence (D.D.).
  • Guy-Moyat B; CHU Limoges (B.G.-M.).
  • Abbey S; Hôpital Privé du Confluent, Nantes (S.A.).
  • Garcia R; CHU Poitiers (R.G.).
  • Césari O; Clinique Saint-Augustin, Bordeaux (O.C.).
  • Badenco N; Hôpital Pitié Salpêtrière, IHU ICAN, Paris (N.B.).
  • Lepillier A; Centre Cardiologique du Nord, Saint-Denis (A.L.).
  • Ninni S; CHU Lille (S.N.).
  • Boulé S; Hôpital Privé Le Bois, Lille (S.B.).
  • Maury P; CHU Toulouse (P.M.).
  • Algalarrondo V; Hôpital Bichat, Unité de Rythmologie, Paris (V.A.).
  • Bakouboula B; Institut Cardiovasculaire de Strasbourg, Clinique RHENA (B.B.).
  • Mansourati J; CHU Brest (J.M.).
  • Lesaffre F; CHU Reims (F.L.).
  • Lagrange P; Clinique St Pierre, Perpignan (P.L.).
  • Bouzeman A; Hôpital Privé de Parly 2, Le Chesnay-Rocquencourt (A.B.).
  • Muresan L; CH Mulhouse (L.M.).
  • Bacquelin R; CH Chambéry (R.B.).
  • Bortone A; ELSAN Hôpital Privé Les Franciscaines, Nîmes (A.B.).
  • Bun SS; CHU Nice, France (S.-S.B.).
  • Pavin D; University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.).
  • Macle L; Department of Medicine, Electrophysiology Service at the Montreal Heart Institute, Canada (L.M.).
  • Martins RP; University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.).
Circ Arrhythm Electrophysiol ; 16(3): e011354, 2023 03.
Article en En | MEDLINE | ID: mdl-36802906
BACKGROUND: Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown. We analyzed the impact of current ablation strategies in a large multicenter study. METHODS: Patients undergoing a redo ablation for AF and presenting durable PVI were included. The freedom from atrial arrhythmia after pulmonary vein-based, linear-based, electrogram-based, and trigger-based ablation strategies were compared. RESULTS: Between 2010 and 2020, 367 patients (67% men, 63±10 years, 44% paroxysmal) underwent a redo ablation for AF recurrences despite durable PVI at 39 centers. After durable PVI was confirmed, linear-based ablation was performed in 219 (60%) patients, electrogram-based ablation in 168 (45%) patients, trigger-based ablation in 101 (27%) patients, and pulmonary vein-based ablation in 56 (15%) patients. Seven patients (2%) did not undergo any additional ablation during the redo procedure. After 22±19 months of follow-up, 122 (33%) and 159 (43%) patients had a recurrence of atrial arrhythmia at 12 and 24 months, respectively. No significant difference in arrhythmia-free survival was observed between the different ablation strategies. Left atrial dilatation was the only independent factor associated with arrhythmia-free survival (HR, 1.59 [95% CI, 1.13-2.23]; P=0.006). CONCLUSIONS: In patients with recurrent AF despite durable PVI, no ablation strategy used alone or in combination during the redo procedure appears to be superior in improving arrhythmia-free survival. Left atrial size is a significant predictor of ablation outcome in this population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Fibrilación Atrial / Ablación por Catéter Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Venas Pulmonares / Fibrilación Atrial / Ablación por Catéter Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Female / Humans / Male Idioma: En Revista: Circ Arrhythm Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos