Linear ablation in addition to circumferential pulmonary vein isolation (Dallas lesion set) does not improve clinical outcome in patients with paroxysmal atrial fibrillation: A prospective randomized study

Tae Hoon Kim, Junbeom Park, Jin Kyu Park, Jae Sun Uhm, Boyoung Joung, Chun Hwang, Moon Hyoung Lee, Hui Nam Pak

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Aims Although the concept of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) was derived from maze surgery, it is unclear if linear ablation in addition to circumferential pulmonary vein isolation (CPVI) reduces the recurrence rate in patients with paroxysmal AF. Therefore, we compared clinical outcomes of CPVI with additional linear ablations (Dallas lesion set) and CPVI in a prospective randomized controlled study among patients with paroxysmal AF. Methods and results This study enrolled 100 paroxysmal AF patients (male 75.0%, 56.4 ± 11.6 years old) who underwent RFCA and were randomly assigned to the CPVI group (n = 50) or the catheter Dallas lesion group (CPVI, posterior box lesion, and anterior linear ablation, n = 50). The catheter Dallas lesion group required longer procedure (190.3 ± 46.3 vs. 161.1 ± 30.3 min, P < 0.001) and ablation times (5345.4 ± 1676.4 vs. 4027.2 ± 878.0 s, P < 0.001) than the CPVI group. Complete bidirectional conduction block rate was 68.0% in the catheter Dallas lesion group and 100% in the CPVI group. Procedure-related complication rates were not significantly different between the catheter Dallas lesion (0%) and CPVI groups (4%, P = 0.157). During the 16.3 ± 4.0 months of follow-up, the clinical recurrence rates were not significantly different between the two groups (16.0% in the catheter Dallas lesion group vs. 12.0% in the CPVI group, P = 0.564), regardless of complete bidirectional conduction block achievement after linear ablation. Conclusion Linear ablation in addition to CPVI (catheter Dallas lesion) did not improve clinical outcomes of RFCA in paroxysmal AF patients and required longer procedure times.

Original languageEnglish
Pages (from-to)388-395
Number of pages8
JournalEuropace
Volume17
Issue number3
DOIs
Publication statusPublished - 2015 Jan 27

Fingerprint

Pulmonary Veins
Atrial Fibrillation
Prospective Studies
Catheters
Catheter Ablation
Recurrence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{a910c43ec28649179c5356fafe95f312,
title = "Linear ablation in addition to circumferential pulmonary vein isolation (Dallas lesion set) does not improve clinical outcome in patients with paroxysmal atrial fibrillation: A prospective randomized study",
abstract = "Aims Although the concept of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) was derived from maze surgery, it is unclear if linear ablation in addition to circumferential pulmonary vein isolation (CPVI) reduces the recurrence rate in patients with paroxysmal AF. Therefore, we compared clinical outcomes of CPVI with additional linear ablations (Dallas lesion set) and CPVI in a prospective randomized controlled study among patients with paroxysmal AF. Methods and results This study enrolled 100 paroxysmal AF patients (male 75.0{\%}, 56.4 ± 11.6 years old) who underwent RFCA and were randomly assigned to the CPVI group (n = 50) or the catheter Dallas lesion group (CPVI, posterior box lesion, and anterior linear ablation, n = 50). The catheter Dallas lesion group required longer procedure (190.3 ± 46.3 vs. 161.1 ± 30.3 min, P < 0.001) and ablation times (5345.4 ± 1676.4 vs. 4027.2 ± 878.0 s, P < 0.001) than the CPVI group. Complete bidirectional conduction block rate was 68.0{\%} in the catheter Dallas lesion group and 100{\%} in the CPVI group. Procedure-related complication rates were not significantly different between the catheter Dallas lesion (0{\%}) and CPVI groups (4{\%}, P = 0.157). During the 16.3 ± 4.0 months of follow-up, the clinical recurrence rates were not significantly different between the two groups (16.0{\%} in the catheter Dallas lesion group vs. 12.0{\%} in the CPVI group, P = 0.564), regardless of complete bidirectional conduction block achievement after linear ablation. Conclusion Linear ablation in addition to CPVI (catheter Dallas lesion) did not improve clinical outcomes of RFCA in paroxysmal AF patients and required longer procedure times.",
author = "Kim, {Tae Hoon} and Junbeom Park and Park, {Jin Kyu} and Uhm, {Jae Sun} and Boyoung Joung and Chun Hwang and Lee, {Moon Hyoung} and Pak, {Hui Nam}",
year = "2015",
month = "1",
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doi = "10.1093/europace/euu245",
language = "English",
volume = "17",
pages = "388--395",
journal = "Europace",
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Linear ablation in addition to circumferential pulmonary vein isolation (Dallas lesion set) does not improve clinical outcome in patients with paroxysmal atrial fibrillation : A prospective randomized study. / Kim, Tae Hoon; Park, Junbeom; Park, Jin Kyu; Uhm, Jae Sun; Joung, Boyoung; Hwang, Chun; Lee, Moon Hyoung; Pak, Hui Nam.

In: Europace, Vol. 17, No. 3, 27.01.2015, p. 388-395.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Linear ablation in addition to circumferential pulmonary vein isolation (Dallas lesion set) does not improve clinical outcome in patients with paroxysmal atrial fibrillation

T2 - A prospective randomized study

AU - Kim, Tae Hoon

AU - Park, Junbeom

AU - Park, Jin Kyu

AU - Uhm, Jae Sun

AU - Joung, Boyoung

AU - Hwang, Chun

AU - Lee, Moon Hyoung

AU - Pak, Hui Nam

PY - 2015/1/27

Y1 - 2015/1/27

N2 - Aims Although the concept of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) was derived from maze surgery, it is unclear if linear ablation in addition to circumferential pulmonary vein isolation (CPVI) reduces the recurrence rate in patients with paroxysmal AF. Therefore, we compared clinical outcomes of CPVI with additional linear ablations (Dallas lesion set) and CPVI in a prospective randomized controlled study among patients with paroxysmal AF. Methods and results This study enrolled 100 paroxysmal AF patients (male 75.0%, 56.4 ± 11.6 years old) who underwent RFCA and were randomly assigned to the CPVI group (n = 50) or the catheter Dallas lesion group (CPVI, posterior box lesion, and anterior linear ablation, n = 50). The catheter Dallas lesion group required longer procedure (190.3 ± 46.3 vs. 161.1 ± 30.3 min, P < 0.001) and ablation times (5345.4 ± 1676.4 vs. 4027.2 ± 878.0 s, P < 0.001) than the CPVI group. Complete bidirectional conduction block rate was 68.0% in the catheter Dallas lesion group and 100% in the CPVI group. Procedure-related complication rates were not significantly different between the catheter Dallas lesion (0%) and CPVI groups (4%, P = 0.157). During the 16.3 ± 4.0 months of follow-up, the clinical recurrence rates were not significantly different between the two groups (16.0% in the catheter Dallas lesion group vs. 12.0% in the CPVI group, P = 0.564), regardless of complete bidirectional conduction block achievement after linear ablation. Conclusion Linear ablation in addition to CPVI (catheter Dallas lesion) did not improve clinical outcomes of RFCA in paroxysmal AF patients and required longer procedure times.

AB - Aims Although the concept of radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) was derived from maze surgery, it is unclear if linear ablation in addition to circumferential pulmonary vein isolation (CPVI) reduces the recurrence rate in patients with paroxysmal AF. Therefore, we compared clinical outcomes of CPVI with additional linear ablations (Dallas lesion set) and CPVI in a prospective randomized controlled study among patients with paroxysmal AF. Methods and results This study enrolled 100 paroxysmal AF patients (male 75.0%, 56.4 ± 11.6 years old) who underwent RFCA and were randomly assigned to the CPVI group (n = 50) or the catheter Dallas lesion group (CPVI, posterior box lesion, and anterior linear ablation, n = 50). The catheter Dallas lesion group required longer procedure (190.3 ± 46.3 vs. 161.1 ± 30.3 min, P < 0.001) and ablation times (5345.4 ± 1676.4 vs. 4027.2 ± 878.0 s, P < 0.001) than the CPVI group. Complete bidirectional conduction block rate was 68.0% in the catheter Dallas lesion group and 100% in the CPVI group. Procedure-related complication rates were not significantly different between the catheter Dallas lesion (0%) and CPVI groups (4%, P = 0.157). During the 16.3 ± 4.0 months of follow-up, the clinical recurrence rates were not significantly different between the two groups (16.0% in the catheter Dallas lesion group vs. 12.0% in the CPVI group, P = 0.564), regardless of complete bidirectional conduction block achievement after linear ablation. Conclusion Linear ablation in addition to CPVI (catheter Dallas lesion) did not improve clinical outcomes of RFCA in paroxysmal AF patients and required longer procedure times.

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U2 - 10.1093/europace/euu245

DO - 10.1093/europace/euu245

M3 - Article

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JO - Europace

JF - Europace

SN - 1099-5129

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