Does Additional Linear Ablation after Circumferential Pulmonary Vein Isolation Improve Clinical Outcome in Patients with Paroxysmal Atrial Fibrillation? Prospective Randomized Study

Hee Sun Mun, Jae Sun Uhm, Hye Jin Hwang, Jong Youn Kim, Boyoung Joung, Moon Hyoung Lee, huinam pak

Research output: Contribution to journalArticle

Abstract

Background: Circumferential pulmonary vein isolation (CPVI) has been considered as the cornerstone for radiofrequency Catheter ablation (RFCA) of atrial fibrillation (AF). However, it is unclear whether linear ablation in addition to CPVI improves clinical outcome. Methods: This study enrolled 156 patients (male 76.3%, 55.8±11.5 years old) who underwent RFCA for paroxysmal AF (PAF) as a prospective randomized study. We compared CPVI (n=52), CPVI+Roof line (CPVI+RL; n=52), and CPVI+RL+posterior inferior line (CPVI+PostBox; n=52) in terms of procedure time, ablation time, and clinical outcome. Results: 1. CPVI group showed shorter total procedure time (180.4± 39.5 min vs. 189.6±29.0 min, 201.7±51.7 min, respectively; p=0.035) and ablation time (4085.5±1384.1 sec vs. 5253.5±1010.9 sec, 5495.0 ±1316.0 sec, respectively; p<0.001) than CPVI+RL and CPVI+PostBox groups. 2. During 15.6±5.0 month follow-up, the recurrence rates three months after RFCA were 11.5% in CPVI, 21.2% in CPVI+RL, and 19.2% in CPVI+PostBox (p=0.440). 3. The achievement rate of bidirectional block was 100.0% in CPVI, 90.4% in CPVI+RL, and 59.6% in CPVI+PostBox. The clinical recurrence rates with or without achieving bidirectional block were not significantly different from each other (p=0.412). Conclusion: In patients with PAF, linear ablations in addition to CPVI did not improve clinical outcome, regardless of bidirectional block achievement, while it prolonged the total procedure and ablation time.

Original languageEnglish
Number of pages1
Journaljournal of arrhythmia
Volume27
Issue number4
DOIs
Publication statusPublished - 2011 Jan 1

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Pulmonary Veins
Atrial Fibrillation
Prospective Studies
Catheter Ablation
Recurrence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{ea7bbdd4cd1646ce92d7e2e9e0dc4951,
title = "Does Additional Linear Ablation after Circumferential Pulmonary Vein Isolation Improve Clinical Outcome in Patients with Paroxysmal Atrial Fibrillation? Prospective Randomized Study",
abstract = "Background: Circumferential pulmonary vein isolation (CPVI) has been considered as the cornerstone for radiofrequency Catheter ablation (RFCA) of atrial fibrillation (AF). However, it is unclear whether linear ablation in addition to CPVI improves clinical outcome. Methods: This study enrolled 156 patients (male 76.3{\%}, 55.8±11.5 years old) who underwent RFCA for paroxysmal AF (PAF) as a prospective randomized study. We compared CPVI (n=52), CPVI+Roof line (CPVI+RL; n=52), and CPVI+RL+posterior inferior line (CPVI+PostBox; n=52) in terms of procedure time, ablation time, and clinical outcome. Results: 1. CPVI group showed shorter total procedure time (180.4± 39.5 min vs. 189.6±29.0 min, 201.7±51.7 min, respectively; p=0.035) and ablation time (4085.5±1384.1 sec vs. 5253.5±1010.9 sec, 5495.0 ±1316.0 sec, respectively; p<0.001) than CPVI+RL and CPVI+PostBox groups. 2. During 15.6±5.0 month follow-up, the recurrence rates three months after RFCA were 11.5{\%} in CPVI, 21.2{\%} in CPVI+RL, and 19.2{\%} in CPVI+PostBox (p=0.440). 3. The achievement rate of bidirectional block was 100.0{\%} in CPVI, 90.4{\%} in CPVI+RL, and 59.6{\%} in CPVI+PostBox. The clinical recurrence rates with or without achieving bidirectional block were not significantly different from each other (p=0.412). Conclusion: In patients with PAF, linear ablations in addition to CPVI did not improve clinical outcome, regardless of bidirectional block achievement, while it prolonged the total procedure and ablation time.",
author = "Mun, {Hee Sun} and Uhm, {Jae Sun} and Hwang, {Hye Jin} and Kim, {Jong Youn} and Boyoung Joung and Lee, {Moon Hyoung} and huinam pak",
year = "2011",
month = "1",
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doi = "10.4020/jhrs.27.OP30_5",
language = "English",
volume = "27",
journal = "Journal of Arrhythmia",
issn = "1880-4276",
publisher = "Elsevier BV",
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Does Additional Linear Ablation after Circumferential Pulmonary Vein Isolation Improve Clinical Outcome in Patients with Paroxysmal Atrial Fibrillation? Prospective Randomized Study. / Mun, Hee Sun; Uhm, Jae Sun; Hwang, Hye Jin; Kim, Jong Youn; Joung, Boyoung; Lee, Moon Hyoung; pak, huinam.

In: journal of arrhythmia, Vol. 27, No. 4, 01.01.2011.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Does Additional Linear Ablation after Circumferential Pulmonary Vein Isolation Improve Clinical Outcome in Patients with Paroxysmal Atrial Fibrillation? Prospective Randomized Study

AU - Mun, Hee Sun

AU - Uhm, Jae Sun

AU - Hwang, Hye Jin

AU - Kim, Jong Youn

AU - Joung, Boyoung

AU - Lee, Moon Hyoung

AU - pak, huinam

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: Circumferential pulmonary vein isolation (CPVI) has been considered as the cornerstone for radiofrequency Catheter ablation (RFCA) of atrial fibrillation (AF). However, it is unclear whether linear ablation in addition to CPVI improves clinical outcome. Methods: This study enrolled 156 patients (male 76.3%, 55.8±11.5 years old) who underwent RFCA for paroxysmal AF (PAF) as a prospective randomized study. We compared CPVI (n=52), CPVI+Roof line (CPVI+RL; n=52), and CPVI+RL+posterior inferior line (CPVI+PostBox; n=52) in terms of procedure time, ablation time, and clinical outcome. Results: 1. CPVI group showed shorter total procedure time (180.4± 39.5 min vs. 189.6±29.0 min, 201.7±51.7 min, respectively; p=0.035) and ablation time (4085.5±1384.1 sec vs. 5253.5±1010.9 sec, 5495.0 ±1316.0 sec, respectively; p<0.001) than CPVI+RL and CPVI+PostBox groups. 2. During 15.6±5.0 month follow-up, the recurrence rates three months after RFCA were 11.5% in CPVI, 21.2% in CPVI+RL, and 19.2% in CPVI+PostBox (p=0.440). 3. The achievement rate of bidirectional block was 100.0% in CPVI, 90.4% in CPVI+RL, and 59.6% in CPVI+PostBox. The clinical recurrence rates with or without achieving bidirectional block were not significantly different from each other (p=0.412). Conclusion: In patients with PAF, linear ablations in addition to CPVI did not improve clinical outcome, regardless of bidirectional block achievement, while it prolonged the total procedure and ablation time.

AB - Background: Circumferential pulmonary vein isolation (CPVI) has been considered as the cornerstone for radiofrequency Catheter ablation (RFCA) of atrial fibrillation (AF). However, it is unclear whether linear ablation in addition to CPVI improves clinical outcome. Methods: This study enrolled 156 patients (male 76.3%, 55.8±11.5 years old) who underwent RFCA for paroxysmal AF (PAF) as a prospective randomized study. We compared CPVI (n=52), CPVI+Roof line (CPVI+RL; n=52), and CPVI+RL+posterior inferior line (CPVI+PostBox; n=52) in terms of procedure time, ablation time, and clinical outcome. Results: 1. CPVI group showed shorter total procedure time (180.4± 39.5 min vs. 189.6±29.0 min, 201.7±51.7 min, respectively; p=0.035) and ablation time (4085.5±1384.1 sec vs. 5253.5±1010.9 sec, 5495.0 ±1316.0 sec, respectively; p<0.001) than CPVI+RL and CPVI+PostBox groups. 2. During 15.6±5.0 month follow-up, the recurrence rates three months after RFCA were 11.5% in CPVI, 21.2% in CPVI+RL, and 19.2% in CPVI+PostBox (p=0.440). 3. The achievement rate of bidirectional block was 100.0% in CPVI, 90.4% in CPVI+RL, and 59.6% in CPVI+PostBox. The clinical recurrence rates with or without achieving bidirectional block were not significantly different from each other (p=0.412). Conclusion: In patients with PAF, linear ablations in addition to CPVI did not improve clinical outcome, regardless of bidirectional block achievement, while it prolonged the total procedure and ablation time.

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