Maintenance of sinus rhythm after electrical cardioversion to identify patients with persistent atrial fibrillation who respond favorably to pulmonary vein isolation: the pre-pacific study.
| Title: | Maintenance of sinus rhythm after electrical cardioversion to identify patients with persistent atrial fibrillation who respond favorably to pulmonary vein isolation: the pre-pacific study. |
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| Authors: | Limite LR; Service de Cardiologie, Hôpital Privé Les Franciscaines, ELSAN, Nîmes, France.; Service de Cardiologie, Clinique Saint Pierre, ELSAN, Perpignan, France.; Laborie G; Service de Cardiologie, Hôpital Privé Les Franciscaines, ELSAN, Nîmes, France.; Ramirez FD; Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.; Albenque JP; Département de Rythmologie, Clinique Pasteur, Toulouse, France.; Combes S; Département de Rythmologie, Clinique Pasteur, Toulouse, France.; Lagrange P; Service de Cardiologie, Clinique Saint Pierre, ELSAN, Perpignan, France.; Khoueiry Z; Service de Cardiologie, Clinique Saint Pierre, ELSAN, Perpignan, France.; Bortone A; Service de Cardiologie, Hôpital Privé Les Franciscaines, ELSAN, Nîmes, France. |
| Source: | Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2024 Oct 11; Vol. 11, pp. 1416975. Date of Electronic Publication: 2024 Oct 11 (Print Publication: 2024). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Frontiers Media S.A Country of Publication: Switzerland NLM ID: 101653388 Publication Model: eCollection Cited Medium: Print ISSN: 2297-055X (Print) Linking ISSN: 2297055X NLM ISO Abbreviation: Front Cardiovasc Med Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Lausanne : Frontiers Media S.A., [2014]- |
| Abstract: | Background: Pulmonary vein isolation (PVI) is successful in approximately 50% of patients with persistent atrial fibrillation (PsAF) at one year. Identifying pre-procedurally the patients who respond favorably to a PVI alone strategy could improve their management. The present study aims to assess the predictive value of clinical response to pre-ablation electrical cardioversion (ECV) to identify the responders to PVI.; Methods: Consecutive patients undergoing catheter ablation for PsAF were retrospectively classified, as "ECV successful" vs. "ECV failure", according to the rhythm of presentation after an ECV performed ≥4 weeks. Clinical and procedural data were analyzed in both groups according to the ablation strategy applied (PVI vs. PVI + substrate modification).; Results: In total, 58 patients (39.4%) had successful ECVs and 89 (60.6%) had failed ECV. Preprocedural characteristics were similar in both groups. Compared to the ECV failure group, patients with successful ECV presented less frequently (34% vs. 60%; P = 0.004) and less extended (21.3 ± 22.2% vs. 38.9 ± 27.4% of LA surface, P = 0.008) low-voltage areas. Over 55 ± 19 weeks of follow-up, AF-free survival was similar in both groups (72.7% vs. 67.8%, p = 0.39). PVI alone resulted in 83% AF-free survival among patients in the ECV successful group at 13 months.; Conclusion: In approximately 40% of patients with PsAF, sinus rhythm can be restored by ECV and maintained for at least 1 month prior to catheter ablation. This clinical response is associated with less abnormal substrate as identified by left atrial voltage mapping and a procedural success rate of >80% with PVI alone.; (© 2024 Limite, Laborie, Ramirez, Albenque, Combes, Lagrange, Khoueiry and Bortone.) |
| Competing Interests: | The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
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| Contributed Indexing: | Keywords: atrial remodeling; electrical cardioversion; persistent atrial fibrillation; pulmonary vein isolation; sinus rhythm |
| Entry Date(s): | Date Created: 20241028 Latest Revision: 20241029 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11502360 |
| DOI: | 10.3389/fcvm.2024.1416975 |
| PMID: | 39465134 |
| Database: | MEDLINE |
Journal Article