Utility of acute arrhythmia termination as an ablation endpoint for induced atrial tachyarrhythmia after complete pulmonary vein isolation during catheter ablation for persistent atrial fibrillation

Young Choi, Sung Hwan Kim, Ju Youn Kim, Yoo Ri Kim, Tae Seok Kim, Youmi Hwang, Ji Hoon Kim, Sung Won Jang, Man Young Lee, Tai Ho Rho, Yong Seog Oh

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Purpose: The presence of inducible atrial tachyarrhythmia after pulmonary vein isolation (PVI) during radiofrequency catheter ablation (RFCA) for persistent atrial fibrillation (AF) may indicate the necessity of further substrate modification, but the optimal ablation endpoint is unknown. We sought to assess the impact of procedural termination of inducible atrial tachyarrhythmia after PVI in comparison with continued atrial tachyarrhythmia after PVI. Methods: Among patients who underwent RFCA for persistent AF, we enrolled 93 patients who were in sinus rhythm after PVI and had inducible atrial tachyarrhythmia and 157 patients with continued atrial tachyarrhythmia after PVI. The impact of acute arrhythmia termination during further substrate modification on recurrence was compared between the two groups. Results: Acute termination was achieved in 51 (54.8%) patients in the induced arrhythmia group and 61 (38.9%) in the continued arrhythmia group. During a mean 35.8 months, acute termination did not significantly reduce arrhythmia recurrence in the induced arrhythmia group (HR 0.712, 95% CI 0.400–1.266, p = 0.247), while it was associated with improved outcome in the continued arrhythmia group (HR 0.590, 95% CI 0.355–0.979, p = 0.038). Acute termination of either induced atrial tachycardia (AT) or induced AF was not associated with improved procedure outcome. Among the continued arrhythmia group, the benefit of acute termination was statistically significant in AT (HR 0.329, 95% CI 0.108–0.997, p = 0.039), but not in AF (HR 0.704, 95% CI 0.396–1.253, p = 0.233) after PVI. Conclusions: Acute termination of induced rhythm is not a reliable ablation endpoint during substrate modification in patients with inducible arrhythmia after PVI.

Original languageEnglish
Pages (from-to)25-34
Number of pages10
JournalJournal of Interventional Cardiac Electrophysiology
Volume54
Issue number1
DOIs
StatePublished - 15 Jan 2019

Bibliographical note

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Atrial fibrillation
  • Inducibility
  • Radiofrequency catheter ablation
  • Substrate modification

Fingerprint

Dive into the research topics of 'Utility of acute arrhythmia termination as an ablation endpoint for induced atrial tachyarrhythmia after complete pulmonary vein isolation during catheter ablation for persistent atrial fibrillation'. Together they form a unique fingerprint.

Cite this