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Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial

BACKGROUND AND OBJECTIVES: Cavotricuspid isthmus (CTI) block is easily achieved, and prophylactic ablation can be performed during atrial fibrillation (AF) ablation. However, the previous study was too small and short-term to clarify the efficacy of this block. METHODS: Patients who underwent cathet...

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Autores principales: Kim, Sung-Hwan, Oh, Yong-Seog, Choi, Young, Hwang, Youmi, Kim, Ju Youn, Kim, Tae-Seok, Kim, Ji-Hoon, Jang, Sung-Won, Lee, Man Young, Joung, Boyoung, Choi, Kee-Joon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779821/
https://www.ncbi.nlm.nih.gov/pubmed/33150753
http://dx.doi.org/10.4070/kcj.2020.0174
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author Kim, Sung-Hwan
Oh, Yong-Seog
Choi, Young
Hwang, Youmi
Kim, Ju Youn
Kim, Tae-Seok
Kim, Ji-Hoon
Jang, Sung-Won
Lee, Man Young
Joung, Boyoung
Choi, Kee-Joon
author_facet Kim, Sung-Hwan
Oh, Yong-Seog
Choi, Young
Hwang, Youmi
Kim, Ju Youn
Kim, Tae-Seok
Kim, Ji-Hoon
Jang, Sung-Won
Lee, Man Young
Joung, Boyoung
Choi, Kee-Joon
author_sort Kim, Sung-Hwan
collection PubMed
description BACKGROUND AND OBJECTIVES: Cavotricuspid isthmus (CTI) block is easily achieved, and prophylactic ablation can be performed during atrial fibrillation (AF) ablation. However, the previous study was too small and short-term to clarify the efficacy of this block. METHODS: Patients who underwent catheter ablation for paroxysmal AF were enrolled, and patients who had previous or induced atrial flutter (AFL) were excluded. We randomly assigned 366 patients to pulmonary vein isolation (PVI) only and prophylactic CTI ablation (PVI vs. PVI+CTI). RESULTS: There was no significant difference in procedure time between the two groups because most CTI blocks were performed during the waiting time after the PVI (176.8±72.6 minutes in PVI vs. 174.2±76.5 minutes in PVI+CTI, p=0.75). All patients were followed up for at least 18 months, and the median follow-up was 3.4 years. The recurrence rate of AF or AFL was not different in the 2 groups (25.7% in PVI vs. 25.7% in PVI+CTI, p=0.92). The recurrence rate of any AFL was not significantly different in the 2 groups (3.3% in PVI vs. 1.6% in PVI+CTI, p=0.31). The recurrence rate of typical AFL also was not different (0.5% in PVI vs. 0.5% in PVI+CTI, p=0.99). CONCLUSIONS: In this large and long-term follow-up study, prophylactic CTI ablation had no benefit in patients with paroxysmal AF without typical AFL. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02031705
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spelling pubmed-77798212021-01-05 Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial Kim, Sung-Hwan Oh, Yong-Seog Choi, Young Hwang, Youmi Kim, Ju Youn Kim, Tae-Seok Kim, Ji-Hoon Jang, Sung-Won Lee, Man Young Joung, Boyoung Choi, Kee-Joon Korean Circ J Original Research BACKGROUND AND OBJECTIVES: Cavotricuspid isthmus (CTI) block is easily achieved, and prophylactic ablation can be performed during atrial fibrillation (AF) ablation. However, the previous study was too small and short-term to clarify the efficacy of this block. METHODS: Patients who underwent catheter ablation for paroxysmal AF were enrolled, and patients who had previous or induced atrial flutter (AFL) were excluded. We randomly assigned 366 patients to pulmonary vein isolation (PVI) only and prophylactic CTI ablation (PVI vs. PVI+CTI). RESULTS: There was no significant difference in procedure time between the two groups because most CTI blocks were performed during the waiting time after the PVI (176.8±72.6 minutes in PVI vs. 174.2±76.5 minutes in PVI+CTI, p=0.75). All patients were followed up for at least 18 months, and the median follow-up was 3.4 years. The recurrence rate of AF or AFL was not different in the 2 groups (25.7% in PVI vs. 25.7% in PVI+CTI, p=0.92). The recurrence rate of any AFL was not significantly different in the 2 groups (3.3% in PVI vs. 1.6% in PVI+CTI, p=0.31). The recurrence rate of typical AFL also was not different (0.5% in PVI vs. 0.5% in PVI+CTI, p=0.99). CONCLUSIONS: In this large and long-term follow-up study, prophylactic CTI ablation had no benefit in patients with paroxysmal AF without typical AFL. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02031705 The Korean Society of Cardiology 2020-09-14 /pmc/articles/PMC7779821/ /pubmed/33150753 http://dx.doi.org/10.4070/kcj.2020.0174 Text en Copyright © 2021. The Korean Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Kim, Sung-Hwan
Oh, Yong-Seog
Choi, Young
Hwang, Youmi
Kim, Ju Youn
Kim, Tae-Seok
Kim, Ji-Hoon
Jang, Sung-Won
Lee, Man Young
Joung, Boyoung
Choi, Kee-Joon
Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial
title Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial
title_full Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial
title_fullStr Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial
title_full_unstemmed Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial
title_short Long-Term Efficacy of Prophylactic Cavotricuspid Isthmus Ablation during Atrial Fibrillation Ablation in Patients Without Typical Atrial Flutter: a Prospective, Multicentre, Randomized Trial
title_sort long-term efficacy of prophylactic cavotricuspid isthmus ablation during atrial fibrillation ablation in patients without typical atrial flutter: a prospective, multicentre, randomized trial
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779821/
https://www.ncbi.nlm.nih.gov/pubmed/33150753
http://dx.doi.org/10.4070/kcj.2020.0174
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