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Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?

BACKGROUND: Catheter ablation of atrial fibrillation (AF) is an established second line therapy for patients with symptomatic paroxysmal AF (PAF) and may be considered as a first line therapy in selected patients who are highly symptomatic, considering patient choice, benefit, and risk, according to...

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Autores principales: Manninger, Martin, Ebner, Jakob, Zweiker, David, Sieghartsleitner, Raphael, Mastnak, Bernadette, Bisping, Egbert, Lercher, Peter, Riedlbauer, Rita, Rotman, Brigitte, Brussee, Helmut, Scherr, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6285381/
https://www.ncbi.nlm.nih.gov/pubmed/30532216
http://dx.doi.org/10.1371/journal.pone.0208994
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author Manninger, Martin
Ebner, Jakob
Zweiker, David
Sieghartsleitner, Raphael
Mastnak, Bernadette
Bisping, Egbert
Lercher, Peter
Riedlbauer, Rita
Rotman, Brigitte
Brussee, Helmut
Scherr, Daniel
author_facet Manninger, Martin
Ebner, Jakob
Zweiker, David
Sieghartsleitner, Raphael
Mastnak, Bernadette
Bisping, Egbert
Lercher, Peter
Riedlbauer, Rita
Rotman, Brigitte
Brussee, Helmut
Scherr, Daniel
author_sort Manninger, Martin
collection PubMed
description BACKGROUND: Catheter ablation of atrial fibrillation (AF) is an established second line therapy for patients with symptomatic paroxysmal AF (PAF) and may be considered as a first line therapy in selected patients who are highly symptomatic, considering patient choice, benefit, and risk, according to recent guidelines. Our study investigated whether a first line vs. second line ablation approach may result in improved sinus rhythm maintenance after ablation. METHODS: A total of 153 patients undergoing pulmonary vein isolation for PAF were included in the study (age 55±12 years, 29% female). Seventy-nine patients underwent first line AF ablation and 74 patients underwent second line AF ablation after failed antiarrhythmic drug therapy. There was no significant difference in baseline characteristics such as age, history of AF, left atrial size or LVEF between groups. Success was defined as atrial tachyarrhythmia free survival during a 12-month follow-up by means of serial ECG Holter monitoring. RESULTS: There was no significant difference in cumulative arrhythmia-free survival between those patients who received AF ablation as a first or second line therapy. Single procedure success was 78% in the first line group vs. 81% in the second line group; multiple procedure success was 90 vs. 91%, (n.s.). Complication rate was 1.3% vs. 1.4% (n.s.). CONCLUSION: Success of AF ablation did not differ between patients who receive ablation as first vs. second line therapy. Based on these data, a trial of AAD therapy before AF ablation may be justified in most patients with symptomatic PAF eligible for rhythm control.
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spelling pubmed-62853812018-12-28 Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation? Manninger, Martin Ebner, Jakob Zweiker, David Sieghartsleitner, Raphael Mastnak, Bernadette Bisping, Egbert Lercher, Peter Riedlbauer, Rita Rotman, Brigitte Brussee, Helmut Scherr, Daniel PLoS One Research Article BACKGROUND: Catheter ablation of atrial fibrillation (AF) is an established second line therapy for patients with symptomatic paroxysmal AF (PAF) and may be considered as a first line therapy in selected patients who are highly symptomatic, considering patient choice, benefit, and risk, according to recent guidelines. Our study investigated whether a first line vs. second line ablation approach may result in improved sinus rhythm maintenance after ablation. METHODS: A total of 153 patients undergoing pulmonary vein isolation for PAF were included in the study (age 55±12 years, 29% female). Seventy-nine patients underwent first line AF ablation and 74 patients underwent second line AF ablation after failed antiarrhythmic drug therapy. There was no significant difference in baseline characteristics such as age, history of AF, left atrial size or LVEF between groups. Success was defined as atrial tachyarrhythmia free survival during a 12-month follow-up by means of serial ECG Holter monitoring. RESULTS: There was no significant difference in cumulative arrhythmia-free survival between those patients who received AF ablation as a first or second line therapy. Single procedure success was 78% in the first line group vs. 81% in the second line group; multiple procedure success was 90 vs. 91%, (n.s.). Complication rate was 1.3% vs. 1.4% (n.s.). CONCLUSION: Success of AF ablation did not differ between patients who receive ablation as first vs. second line therapy. Based on these data, a trial of AAD therapy before AF ablation may be justified in most patients with symptomatic PAF eligible for rhythm control. Public Library of Science 2018-12-07 /pmc/articles/PMC6285381/ /pubmed/30532216 http://dx.doi.org/10.1371/journal.pone.0208994 Text en © 2018 Manninger et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Manninger, Martin
Ebner, Jakob
Zweiker, David
Sieghartsleitner, Raphael
Mastnak, Bernadette
Bisping, Egbert
Lercher, Peter
Riedlbauer, Rita
Rotman, Brigitte
Brussee, Helmut
Scherr, Daniel
Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?
title Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?
title_full Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?
title_fullStr Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?
title_full_unstemmed Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?
title_short Is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?
title_sort is there a difference in rhythm outcome between patients undergoing first line versus second line paroxysmal atrial fibrillation ablation?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6285381/
https://www.ncbi.nlm.nih.gov/pubmed/30532216
http://dx.doi.org/10.1371/journal.pone.0208994
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