Long-term impact of catheter ablation on arrhythmia burden in low-risk patients with paroxysmal atrial fibrillation: The CLOSE to CURE study.
Ablation
Atrial fibrillation
Burden
Insertable cardiac monitor
Pulmonary vein isolation
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
11
09
2019
pubmed:
11
11
2019
medline:
23
6
2021
entrez:
11
11
2019
Statut:
ppublish
Résumé
Few studies evaluated the impact of catheter ablation (CA) on atrial tachyarrhythmia (ATA) burden in paroxysmal atrial fibrillation (AF). In the prospective, patient-controlled CLOSE to CURE study, we determined the longer-term impact of optimized CA on ATA burden by using an insertable cardiac monitor (ICM). A total of 105 patients with paroxysmal AF were implanted with an ICM 65 (interquartile range [IQR] 61-78) days before CA. CA consisted of contact force-guided pulmonary vein isolation targeting an intertag distance of ≤6 mm and a region-specific ablation index. The primary end point was reduction in ICM-detected ATA burden; secondary end points were single-procedure freedom from ATA, quality of life, and adverse events. The mean age was 62 ± 8 years; the median CHA CA has become an effective procedure in paroxysmal AF, with a major impact on ICM-detected ATA burden. Whereas conventional survival analysis suggests a progressive decline in efficacy, we observed that burden reduction is maintained at longer follow-up. These data imply that ATA burden is a more optimal end point for assessing ablation efficacy.
Sections du résumé
BACKGROUND
Few studies evaluated the impact of catheter ablation (CA) on atrial tachyarrhythmia (ATA) burden in paroxysmal atrial fibrillation (AF).
OBJECTIVE
In the prospective, patient-controlled CLOSE to CURE study, we determined the longer-term impact of optimized CA on ATA burden by using an insertable cardiac monitor (ICM).
METHODS
A total of 105 patients with paroxysmal AF were implanted with an ICM 65 (interquartile range [IQR] 61-78) days before CA. CA consisted of contact force-guided pulmonary vein isolation targeting an intertag distance of ≤6 mm and a region-specific ablation index. The primary end point was reduction in ICM-detected ATA burden; secondary end points were single-procedure freedom from ATA, quality of life, and adverse events.
RESULTS
The mean age was 62 ± 8 years; the median CHA
CONCLUSION
CA has become an effective procedure in paroxysmal AF, with a major impact on ICM-detected ATA burden. Whereas conventional survival analysis suggests a progressive decline in efficacy, we observed that burden reduction is maintained at longer follow-up. These data imply that ATA burden is a more optimal end point for assessing ablation efficacy.
Identifiants
pubmed: 31707159
pii: S1547-5271(19)30997-X
doi: 10.1016/j.hrthm.2019.11.004
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02925624']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
535-543Informations de copyright
Copyright © 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.