The efficacy of ablation based on the combined use of the dominant frequency and complex fractionated atrial electrograms for non-paroxysmal atrial fibrillation

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• 作者：Koji Kumagai ; MD ; PhD ; ^{kkumagai4917@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Masahiro Nakano ; MD ; Daisuke Kutsuzawa ; MD ; PhD ; Yoshiaki Yamaguchi ; MD ; PhD ; Kentaro Minami ; MD ; Shigeru Oshima ; MD ; PhD ; FJCC
• 关键词：Atrial fibrillation ; Ablation ; Dominant frequency ; Pulmonary vein isolation
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：67
• 期：6
• 页码：545-550
• 全文大小：603 K

文摘

This study aimed to evaluate an approach for an endpoint of non-inducibility using a combined high-dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) ablation following circumferential pulmonary vein isolation (PVI) in a sequential fashion, including linear ablation as compared to PVI alone.

Methods and results

A total of 84 non-paroxysmal patients with atrial fibrillation (AF) were investigated retrospectively. The AF patients were divided into two groups: patients with PVI following a combined high-DF and continuous CFAE ablation with linear ablation (substrate modification group, n = 59) and those with PVI alone (n = 25). DF sites of ≥8 Hz and then continuous CFAE sites defined by fractionation intervals of ≤50 ms were modified after PVI. The ablation endpoint was non-inducibility. Atrial tachyarrhythmias (ATs) could not be induced in 54 of 59 (92%) patients after a sequential ablation, and in 18 of 25 (64%) with PVI alone. The ATs freedom without antiarrhythmic drugs in the substrate modification group was significantly greater than that in those with PVI alone after 1 procedure during 12 months of follow-up (78.6% vs. 53.8%, log-rank test p = 0.039).

Conclusion

This sequential approach using a substrate based ablation was associated with a better clinical long-term outcome as compared to PVI alone.