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Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: The benefit of an anterior mitral line (AML) in patients with persistent atrial fibrillation (AF) and anterior atrial scar undergoing ablation has never been investigated. OBJECTIVE: to evaluate the outcomes of AML on top of standa...

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Autores principales: Bergonti, M, Spera, F R, Gonzalez Ferrero, T, Nsahlai, M, Saenen, J, Huybrechts, W, Miljoen, H, Heidbuchel, H, Valderrabano, M, Rodriguez Manero, M, Sarkozy, A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10207524/
http://dx.doi.org/10.1093/europace/euad122.676
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author Bergonti, M
Spera, F R
Gonzalez Ferrero, T
Nsahlai, M
Saenen, J
Huybrechts, W
Miljoen, H
Heidbuchel, H
Valderrabano, M
Rodriguez Manero, M
Sarkozy, A
author_facet Bergonti, M
Spera, F R
Gonzalez Ferrero, T
Nsahlai, M
Saenen, J
Huybrechts, W
Miljoen, H
Heidbuchel, H
Valderrabano, M
Rodriguez Manero, M
Sarkozy, A
author_sort Bergonti, M
collection PubMed
description FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: The benefit of an anterior mitral line (AML) in patients with persistent atrial fibrillation (AF) and anterior atrial scar undergoing ablation has never been investigated. OBJECTIVE: to evaluate the outcomes of AML on top of standard treatment, compared to standard treatment alone (no-AML), in this subset of patients. METHODS: Patients with persistent AF and anterior low voltage zone (LVZ) treated with AML in three Centers were retrospectively enrolled. These patients were matched in a 1:1 fashion with patients with persistent AF and anterior LVZ, who underwent conventional ablation, in the same centers. Matching parameters were: age, LVZ burden, and repeated ablation. Primary endpoint was AF/atrial tachycardia (AT) recurrence. RESULTS: 186 patients (66±9 years, 34% women) were selected and included into two matched groups. Bidirectional conduction block was achieved in 95% of AML. After a median follow-up of 2 years, AF/AT recurrence occurred in 29% of the patients in the AML-group, vs. 48% in the No-AML-group (log-Rank p=0.024) (Figure 1). At Cox-regression multivariate­-analysis left atrial volume (HR 1.03, p=0.006) and AML (HR 0.46, p=0.003) were significantly associated with the primary endpoint. At univariate logistic-regression, lower BMI, older age, extensive anterior LVZ and the position of the left atrial activation breakthrough away from the AML (Figure 2), were associated with first-pass AML block. CONCLUSION: In this retrospective matched analysis of patients with persistent AF and anterior scar, AML on top of standard treatment was associated with improved AF/AT-free survival compared with matched patients treated with standard treatment alone. [Figure: see text] [Figure: see text]
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spelling pubmed-102075242023-05-25 Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study Bergonti, M Spera, F R Gonzalez Ferrero, T Nsahlai, M Saenen, J Huybrechts, W Miljoen, H Heidbuchel, H Valderrabano, M Rodriguez Manero, M Sarkozy, A Europace 9.4.4 - Catheter Ablation of Arrhythmias FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: The benefit of an anterior mitral line (AML) in patients with persistent atrial fibrillation (AF) and anterior atrial scar undergoing ablation has never been investigated. OBJECTIVE: to evaluate the outcomes of AML on top of standard treatment, compared to standard treatment alone (no-AML), in this subset of patients. METHODS: Patients with persistent AF and anterior low voltage zone (LVZ) treated with AML in three Centers were retrospectively enrolled. These patients were matched in a 1:1 fashion with patients with persistent AF and anterior LVZ, who underwent conventional ablation, in the same centers. Matching parameters were: age, LVZ burden, and repeated ablation. Primary endpoint was AF/atrial tachycardia (AT) recurrence. RESULTS: 186 patients (66±9 years, 34% women) were selected and included into two matched groups. Bidirectional conduction block was achieved in 95% of AML. After a median follow-up of 2 years, AF/AT recurrence occurred in 29% of the patients in the AML-group, vs. 48% in the No-AML-group (log-Rank p=0.024) (Figure 1). At Cox-regression multivariate­-analysis left atrial volume (HR 1.03, p=0.006) and AML (HR 0.46, p=0.003) were significantly associated with the primary endpoint. At univariate logistic-regression, lower BMI, older age, extensive anterior LVZ and the position of the left atrial activation breakthrough away from the AML (Figure 2), were associated with first-pass AML block. CONCLUSION: In this retrospective matched analysis of patients with persistent AF and anterior scar, AML on top of standard treatment was associated with improved AF/AT-free survival compared with matched patients treated with standard treatment alone. [Figure: see text] [Figure: see text] Oxford University Press 2023-05-24 /pmc/articles/PMC10207524/ http://dx.doi.org/10.1093/europace/euad122.676 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle 9.4.4 - Catheter Ablation of Arrhythmias
Bergonti, M
Spera, F R
Gonzalez Ferrero, T
Nsahlai, M
Saenen, J
Huybrechts, W
Miljoen, H
Heidbuchel, H
Valderrabano, M
Rodriguez Manero, M
Sarkozy, A
Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study
title Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study
title_full Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study
title_fullStr Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study
title_full_unstemmed Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study
title_short Anterior mitral line in patients with persistent AF and anterior scar: a multicenter matched comparison. The MiLine Study
title_sort anterior mitral line in patients with persistent af and anterior scar: a multicenter matched comparison. the miline study
topic 9.4.4 - Catheter Ablation of Arrhythmias
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10207524/
http://dx.doi.org/10.1093/europace/euad122.676
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