Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study-Reference-Cited by-同舟云学术

Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study

Published:2023-03 Issue:3 Volume:16 Page:
ISSN:1941-3149
Container-title:Circulation: Arrhythmia and Electrophysiology
language:en
Short-container-title:Circ: Arrhythmia and Electrophysiology

Author:

Benali Karim¹^ORCID,Barré Valentin²,Hermida Alexis³^ORCID,Galand Vincent²,Milhem Antoine⁴,Philibert Séverine⁵^ORCID,Boveda Serge⁶^ORCID,Bars Clément⁷,Anselme Frédéric⁸^ORCID,Maille Baptiste⁹,André Clémentine¹⁰,Behaghel Albin¹¹,Moubarak Ghassan¹²,Clémenty Nicolas¹³^ORCID,Da Costa Antoine¹⁴,Arnaud Marine¹⁵^ORCID,Venier Sandrine¹⁶,Sebag Frédéric¹⁷,Jésel-Morel Laurence¹⁸,Sagnard Audrey¹⁹^ORCID,Champ-Rigot Laure²⁰^ORCID,Dang Duc²¹^ORCID,Guy-Moyat Benoit²²,Abbey Selim²³^ORCID,Garcia Rodrigue²⁴^ORCID,Césari Olivier²⁵,Badenco Nicolas²⁶^ORCID,Lepillier Antoine²⁷^ORCID,Ninni Sandro²⁸^ORCID,Boulé Stéphane²⁹,Maury Philippe³⁰^ORCID,Algalarrondo Vincent³¹,Bakouboula Babé³²^ORCID,Mansourati Jacques³³,Lesaffre François³⁴^ORCID,Lagrange Philippe³⁵,Bouzeman Abdeslam³⁶^ORCID,Muresan Lucian³⁷^ORCID,Bacquelin Raoul³⁸^ORCID,Bortone Agustin³⁹^ORCID,Bun Sok-Sithikun⁴⁰,Pavin Dominique²^ORCID,Macle Laurent⁴¹^ORCID,Martins Raphaël P.²^ORCID

Affiliation:

1. CHU Saint Etienne, University of Rennes, INSERM, LTSI -UMR 1099, Rennes (K.B.).

2. University of Rennes, CHU Rennes, INSERM, LTSI–UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.).

3. CHU d’Amiens, Amiens (A.H.).

4. CH La Rochelle (A.M.).

5. Hôpital Européen Georges Pompidou, Paris (S.P.).

6. Cardiology-Heart Rhythm Management Department, Clinique Pasteur, Toulouse (S.B.).

7. Clinique Saint-Joseph, Marseille (C.B.).

8. CHU Rouen, Rouen (F.A.).

9. CHU Marseille (B.M.).

10. CHU Bordeaux (C.A.).

11. Clinique Saint-Joseph, Trelazé (A.B.).

12. Clinique Ambroise Paré, Neuilly-Sur-Seine, Paris (G.M.).

13. CHU Tours (N.C.).

14. CHU Saint Etienne (A.D.C.).

15. CHU Nantes (M.A.).

16. CHU Grenoble (S.V.).

17. Rythmologie, Institut Mutualiste Montsouris, Paris (F.S.).

18. CHU Strasbourg (L.J.-M.).

19. CHU Dijon (A.S.).

20. CHU Caen (L.C.-R.).

21. CH Aix-en-Provence (D.D.).

22. CHU Limoges (B.G.-M.).

23. Hôpital Privé du Confluent, Nantes (S.A.).

24. CHU Poitiers (R.G.).

25. Clinique Saint-Augustin, Bordeaux (O.C.).

26. Hôpital Pitié Salpêtrière, IHU ICAN, Paris (N.B.).

27. Centre Cardiologique du Nord, Saint-Denis (A.L.).

28. CHU Lille (S.N.).

29. Hôpital Privé Le Bois, Lille (S.B.).

30. CHU Toulouse (P.M.).

31. Hôpital Bichat, Unité de Rythmologie, Paris (V.A.).

32. Institut Cardiovasculaire de Strasbourg, Clinique RHENA (B.B.).

33. CHU Brest (J.M.).

34. CHU Reims (F.L.).

35. Clinique St Pierre, Perpignan (P.L.).

36. Hôpital Privé de Parly 2, Le Chesnay-Rocquencourt (A.B.).

37. CH Mulhouse (L.M.).

38. CH Chambéry (R.B.).

39. ELSAN Hôpital Privé Les Franciscaines, Nîmes (A.B.).

40. CHU Nice, France (S.-S.B.).

41. Department of Medicine, Electrophysiology Service at the Montreal Heart Institute, Canada (L.M.).

Abstract

Background: Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown. We analyzed the impact of current ablation strategies in a large multicenter study. Methods: Patients undergoing a redo ablation for AF and presenting durable PVI were included. The freedom from atrial arrhythmia after pulmonary vein-based, linear-based, electrogram-based, and trigger-based ablation strategies were compared. Results: Between 2010 and 2020, 367 patients (67% men, 63±10 years, 44% paroxysmal) underwent a redo ablation for AF recurrences despite durable PVI at 39 centers. After durable PVI was confirmed, linear-based ablation was performed in 219 (60%) patients, electrogram-based ablation in 168 (45%) patients, trigger-based ablation in 101 (27%) patients, and pulmonary vein-based ablation in 56 (15%) patients. Seven patients (2%) did not undergo any additional ablation during the redo procedure. After 22±19 months of follow-up, 122 (33%) and 159 (43%) patients had a recurrence of atrial arrhythmia at 12 and 24 months, respectively. No significant difference in arrhythmia-free survival was observed between the different ablation strategies. Left atrial dilatation was the only independent factor associated with arrhythmia-free survival (HR, 1.59 [95% CI, 1.13–2.23]; P =0.006). Conclusions: In patients with recurrent AF despite durable PVI, no ablation strategy used alone or in combination during the redo procedure appears to be superior in improving arrhythmia-free survival. Left atrial size is a significant predictor of ablation outcome in this population.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Reference34 articles.

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3. Use of Ablation Index-Guided Ablation Results in High Rates of Durable Pulmonary Vein Isolation and Freedom From Arrhythmia in Persistent Atrial Fibrillation Patients

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