Significant reduction of atrial defibrillation threshold and inducibility by catheter ablation of atrial fibrillation

Eui Seock Hwang, Gi Byung Nam, Boyoung Joung, Junbeom Park, Jihei Sara Lee, Jaemin Shim, Jae Sun Uhm, Moon Hyoung Lee, Hui Nam Pak

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has antiarrhythmic effects by multiple mechanisms. We hypothesized that RFCA curtails atrial defibrillation threshold (A-DFT) and postablation induction pacing cycle length (iPCL), making critical mass reduction one potential mechanism by which antiarrhythmic effect is achieved. Methods: We included 289 patients with AF (male 77.9%, 55.7 ± 10.8 years old; 197 paroxysmal AF: 92 persistent AF) who underwent RFCA. A-DFT (serial internal cardioversion 2, 3, 5, 7, and 10 J) and iPCL (serial 10 mA 10-second atrial pacing with pacing cycle length 250, 200, 190, 180, 170, 160, and 150 ms) were evaluated before and after RFCA. Results: (1) RFCA of AF reduced the A-DFT from 6.7 ± 3.7 J to 3.0 ± 3.0 J (P < 0.001). (2) AF ablation reduced AF inducibility from 95.4% before the procedure to 56.3% after the procedure (P < 0.001), and the iPCL from 194.8 ± 32.6 to 160.9 ± 26.2 ms (P < 0.001). (3) In patients who underwent a greater number of ablation lines, the post-RFCA A-DFT (P < 0.001) was lower, and %ΔA-DFT (P = 0.003) and proportion of atrial tachycardia (P = 0.022) were higher than those with a lower number of ablation lines. Conclusion: AF ablation significantly reduced A-DFT, AF inducibility, and iPCL, and the degree of their reduction was related to the number of ablation lines. (PACE 2012;35:1428-1435)

Original languageEnglish
Pages (from-to)1428-1435
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume35
Issue number12
DOIs
Publication statusPublished - 2012 Dec 1

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Catheter Ablation
Atrial Fibrillation
Electric Countershock
Tachycardia

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Hwang, Eui Seock ; Nam, Gi Byung ; Joung, Boyoung ; Park, Junbeom ; Lee, Jihei Sara ; Shim, Jaemin ; Uhm, Jae Sun ; Lee, Moon Hyoung ; Pak, Hui Nam. / Significant reduction of atrial defibrillation threshold and inducibility by catheter ablation of atrial fibrillation. In: PACE - Pacing and Clinical Electrophysiology. 2012 ; Vol. 35, No. 12. pp. 1428-1435.
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abstract = "Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has antiarrhythmic effects by multiple mechanisms. We hypothesized that RFCA curtails atrial defibrillation threshold (A-DFT) and postablation induction pacing cycle length (iPCL), making critical mass reduction one potential mechanism by which antiarrhythmic effect is achieved. Methods: We included 289 patients with AF (male 77.9{\%}, 55.7 ± 10.8 years old; 197 paroxysmal AF: 92 persistent AF) who underwent RFCA. A-DFT (serial internal cardioversion 2, 3, 5, 7, and 10 J) and iPCL (serial 10 mA 10-second atrial pacing with pacing cycle length 250, 200, 190, 180, 170, 160, and 150 ms) were evaluated before and after RFCA. Results: (1) RFCA of AF reduced the A-DFT from 6.7 ± 3.7 J to 3.0 ± 3.0 J (P < 0.001). (2) AF ablation reduced AF inducibility from 95.4{\%} before the procedure to 56.3{\%} after the procedure (P < 0.001), and the iPCL from 194.8 ± 32.6 to 160.9 ± 26.2 ms (P < 0.001). (3) In patients who underwent a greater number of ablation lines, the post-RFCA A-DFT (P < 0.001) was lower, and {\%}ΔA-DFT (P = 0.003) and proportion of atrial tachycardia (P = 0.022) were higher than those with a lower number of ablation lines. Conclusion: AF ablation significantly reduced A-DFT, AF inducibility, and iPCL, and the degree of their reduction was related to the number of ablation lines. (PACE 2012;35:1428-1435)",
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Significant reduction of atrial defibrillation threshold and inducibility by catheter ablation of atrial fibrillation. / Hwang, Eui Seock; Nam, Gi Byung; Joung, Boyoung; Park, Junbeom; Lee, Jihei Sara; Shim, Jaemin; Uhm, Jae Sun; Lee, Moon Hyoung; Pak, Hui Nam.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 35, No. 12, 01.12.2012, p. 1428-1435.

Research output: Contribution to journalArticle

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T1 - Significant reduction of atrial defibrillation threshold and inducibility by catheter ablation of atrial fibrillation

AU - Hwang, Eui Seock

AU - Nam, Gi Byung

AU - Joung, Boyoung

AU - Park, Junbeom

AU - Lee, Jihei Sara

AU - Shim, Jaemin

AU - Uhm, Jae Sun

AU - Lee, Moon Hyoung

AU - Pak, Hui Nam

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N2 - Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has antiarrhythmic effects by multiple mechanisms. We hypothesized that RFCA curtails atrial defibrillation threshold (A-DFT) and postablation induction pacing cycle length (iPCL), making critical mass reduction one potential mechanism by which antiarrhythmic effect is achieved. Methods: We included 289 patients with AF (male 77.9%, 55.7 ± 10.8 years old; 197 paroxysmal AF: 92 persistent AF) who underwent RFCA. A-DFT (serial internal cardioversion 2, 3, 5, 7, and 10 J) and iPCL (serial 10 mA 10-second atrial pacing with pacing cycle length 250, 200, 190, 180, 170, 160, and 150 ms) were evaluated before and after RFCA. Results: (1) RFCA of AF reduced the A-DFT from 6.7 ± 3.7 J to 3.0 ± 3.0 J (P < 0.001). (2) AF ablation reduced AF inducibility from 95.4% before the procedure to 56.3% after the procedure (P < 0.001), and the iPCL from 194.8 ± 32.6 to 160.9 ± 26.2 ms (P < 0.001). (3) In patients who underwent a greater number of ablation lines, the post-RFCA A-DFT (P < 0.001) was lower, and %ΔA-DFT (P = 0.003) and proportion of atrial tachycardia (P = 0.022) were higher than those with a lower number of ablation lines. Conclusion: AF ablation significantly reduced A-DFT, AF inducibility, and iPCL, and the degree of their reduction was related to the number of ablation lines. (PACE 2012;35:1428-1435)

AB - Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has antiarrhythmic effects by multiple mechanisms. We hypothesized that RFCA curtails atrial defibrillation threshold (A-DFT) and postablation induction pacing cycle length (iPCL), making critical mass reduction one potential mechanism by which antiarrhythmic effect is achieved. Methods: We included 289 patients with AF (male 77.9%, 55.7 ± 10.8 years old; 197 paroxysmal AF: 92 persistent AF) who underwent RFCA. A-DFT (serial internal cardioversion 2, 3, 5, 7, and 10 J) and iPCL (serial 10 mA 10-second atrial pacing with pacing cycle length 250, 200, 190, 180, 170, 160, and 150 ms) were evaluated before and after RFCA. Results: (1) RFCA of AF reduced the A-DFT from 6.7 ± 3.7 J to 3.0 ± 3.0 J (P < 0.001). (2) AF ablation reduced AF inducibility from 95.4% before the procedure to 56.3% after the procedure (P < 0.001), and the iPCL from 194.8 ± 32.6 to 160.9 ± 26.2 ms (P < 0.001). (3) In patients who underwent a greater number of ablation lines, the post-RFCA A-DFT (P < 0.001) was lower, and %ΔA-DFT (P = 0.003) and proportion of atrial tachycardia (P = 0.022) were higher than those with a lower number of ablation lines. Conclusion: AF ablation significantly reduced A-DFT, AF inducibility, and iPCL, and the degree of their reduction was related to the number of ablation lines. (PACE 2012;35:1428-1435)

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