Impact of rotor ablation in non-paroxysmal AF patients: Findings from the per-protocol population of the OASIS trial at long-term follow-up - 17/12/18

Doi : 10.1016/j.ahj.2018.05.021

Sanghamitra Mohanty, MD MS FHRS ^a, Carola Gianni, MD ^a, Chintan Trivedi, MD MPH ^a, Tamara Metz, BSN RN ^a, Rong Bai, MD FHRS ^a,^b, Amin Al-Ahmad, MD ^a, Shane Bailey, MD ^a, John David Burkhardt, MD ^a, G. Joseph Gallinghouse, MD ^a, Rodney Horton, MD ^a, Patrick M. Hranitzky, MD ^a, Javier E. Sanchez, MD ^a, Luigi Di Biase, MD PHD FHRS ^a, Andrea Natale, MD, FACC FHRS FESC ^a,^c,^d,^e,^f,^{^⁎}
^a Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
^b Beijing Anzhen Hospital, Capital Medical University, Beijing, China
^c Electrophysiology and Arrhythmia Services, California Pacific Medical Center, San Francisco, CA, USA
^d Interventional Electrophysiology, Scripps Clinic, La Jolla, CA, USA
^e Metro Health Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
^f Division of Cardiology, Stanford University, Stanford, CA, USA

^⁎Reprint requests: Andrea Natale, MD, Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 N. IH-35, Suite 720, Austin, TX 78705.Texas Cardiac Arrhythmia InstituteSt. David's Medical Center3000 N. IH-35, Suite 720AustinTX78705

Abstract

The objective of this study was to evaluate the long-term efficacy of FIRM ablation with PVAI vs PVAI plus posterior wall isolation (PWI) and non-PV trigger ablation in persistent (PeAF) and long-standing persistent AF (LSPAF) patients. The procedure time was recorded to be 180.6 ± 35.9 and 124.03 ± 45.4 minutes in the FIRM+PVI and PVI + PWI + non-PV trigger ablation group respectively. At 24-month follow-up, 24% (95% CI 8.7%–37.8%) in the FIRM-ablation group and 48% (95% CI 27.6–63.3%) in the non-PV trigger ablation group remained arrhythmia-free off-antiarrhythmic drugs after a single procedure.

Clinical Trial Registration: ClinicalTrials.gov (Identifier: NCT02533843).

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Plan

Methods

Ablation procedure

FIRM-mapping^{Gianni C., Mohanty S., Di Biase L., et al. Acute and early outcomes of focal impulse and rotor modulation (FIRM)-guided rotors-only ablation in patients with non-paroxysmal atrial fibrillation Heart Rhythm 2016 ; 13 (4) : 830-835

, Narayan S.M., Baykaner T., Clopton P., et al. Ablation of rotor and focal sources reduces late recurrence of atrial fibrillation compared with trigger ablation alone: extended follow-up of the CONFIRM trial (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation) J Am Coll Cardiol 2014 ; 63 (17) : 1761-1768}

Disclosures:
Dr. Di Biase is a consultant for Biosense Webster, Boston Scientific, Stereotaxis and St Jude Medical. Dr. Di Biase received speaker honoraria/travel from Medtronic, Atricure, EPiEP and Biotronik.
Dr. Natale received speaker honorariums from Boston Scientific, Biosense Webster, St. Jude Medical, Biotronik and Medtronic, Dr Natale is a consultant for Biosense Webster, St Jude Medical and Janssen.
Dr Burkhardt is a consultant for Biosense-Webster and Stereotaxis.
All the remaining authors have no disclosures.

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Vol 205

P. 145-148 - novembre 2018 Retour au numéro

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Impact of rotor ablation in non-paroxysmal AF patients: Findings from the per-protocol population of the OASIS trial at long-term follow-up - 17/12/18

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