Clin Res Cardiol 101, Suppl 1, April 2012

P1308 - Does The Ablation Of Complex Fractionated Atrial Electrograms Increase Ablation Success In Long-Lasting Persistent Atrial Fibrillation? Results From The German Ablation Registry
 
M. Schlößer1, T. Lawrenz1, R. Becker2, J. Tebbenjohanns3, J. Brachmann4, D. Andresen5, B.-D. Gonska6, G. Richardt7, M. Horack8, J. Senges8, C. Stellbrink1
 
1Klinik für Kardiologie & Intensivmedizin, Klinikum Bielefeld, Bielefeld; 2Innere Med. III, Kardiologie, Angiologie u. Pneumologie, Universitätsklinikum Heidelberg, Heidelberg; 3Med. Klinik I, Klinikum Hildesheim GmbH, Hildesheim; 4II. Medizinische Klinik - Kardiologie, Angiologie, Pneumologie, Klinikum Coburg, Coburg; 5Klinik für Innere Medizin, Kardiologie u. konserv. Intensivmed., Vivantes Klinikum Am Urban, Berlin; 6Med. Klinik III, Kardiologie, St. Vincentius-Kliniken gAG, Karlsruhe; 7Herz-Kreislauf-Zentrum, Segeberger Kliniken GmbH, Bad Segeberg; 8Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg, Ludwigshafen;
 
Introduction: Pulmonary vein isolation (PVI) is a well-established therapeutic option in treatment of paroxysmal and long-lasting persistent atrial fibrillation (AF). Especially in ablation of long-lasting persistent AF the ablation of complex fractionated atrial electrograms (CFAE) has been used as an additional option because substrate modification is usually required.
Hypothesis:
Does ablation of CFAE in addition to PVI increase ablation success in patients with long-lasting persistent AF? Methods: Patient and procedural data as well as acute and long-term outcome data from 435 Pts. (mean age 63,3 yrs., 340 m, 95 f) with ablation of long-lasting persistent AF were prospectively collected in 55 centres. One-year follow-up (1yFU) data were gathered by telephone call. Data collection and the statistical analysis were performed for the German Ablation Registry organized by the Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany.
Results:
In 325 Pts. ablation of long-lasting persistent AF was performed without and in 110 Pts. with ablation of CFAE. The baseline clinical characteristics were not different except more re-dos in the CFAE group (38,3 % vs. 21,8 % p<0,01) and more pts. with left ventricular dysfunction in the non-CFAE group (24,0 % vs. 8,8 % p<0,01). The acute success rate differed statistically significant (96,6% without vs. 91,8% with CFAE p<0,05). The acute recurrence rate of AF until hospital discharge was also statistically significant different (12 % without vs. 20,9% with CFAE p<0,05). 1yFU data could be obtained in 73,6 % of Pts. without CFAE ablation and in 69,8 % of Pts. with CFAE ablation. At 1yFU the recurrence rate was 57,4% without CFAE ablation vs. 53,2% with CFAE ablation (p=0,52). Median procedure time ( 205 vs. 175 min, p<0.001), application duration (63 vs. 35,8 min, p<0.001) and the fluroscopy time (33 min vs. 23 min, p<0,001) were longer in the CFAE pts.. The dose area product (4052 cGy*cm2 vs. 3835 cGy*cm2, p=0,44) was not different in the groups.
Conclusions:
These data suggest that ablation of CFAE in addition to PVI versus PVI alone does not lead to an increase in ablation success regarding to the 1yFU recurrence rate of AF.
Limitations:
-non-randomized registry data-, -incomplete follow-up-, -post-hoc analysis, -different contingent of re-dos in the groups-
 
Clin Res Cardiol 101, Suppl 1, April 2012
Zitierung mit Vortrags- oder Posternummer s.o.
DOI 10.1007/s00392-012-1100-6

http://www.abstractserver.de/dgk2012/ft/abstracts/P1308.htm