Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016
Abstract Background and purpose In expectation of better outcome of catheter ablation of atrial fibrillation (AF), several strategies of extra‐PV (pulmonary vein) substrate modification have been utilized. We assessed whether substrate modification or ablation of extra‐PV source is a predictor of co...
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doaj-b6f14479cbb746f38d5815736ea8ac842020-11-25T03:44:37ZengWileyJournal of Arrhythmia1880-42761883-21482018-08-0134443544010.1002/joa3.12081Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016Yuji Murakawa0Teiichi Yamane1Masahiko Goya2Koichi Inoue3Shigeto Naito4Koichiro Kumagai5Yasushi Miyauchi6Norishige Morita7Akihiko Nogami8Morio Shoda9Ken Okumura10Kenzo Hirao11on behalf of the Japanese Heart Rhythm Society MembersFourth Department of Internal Medicine Teikyo University School of Medicine Kawasaki JapanThe Department of Cardiology The Jikei University School of Medicine Tokyo JapanHeart Rhythm Center Tokyo Medical and Dental University Tokyo JapanCardiovascular Center Sakurabashi Watanabe Hospital Osaka JapanDivision of Cardiology Gunma Prefectural Cardiovascular Center Gunma JapanHeart Rhythm Center Fukuoka Sanno Hospital Fukuoka JapanDivision of Cardiology Nippon Medical School Tokyo JapanDivision of Cardiology Tokai University Hachioji Hospital Hachioji JapanCardiovascular Division Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Cardiology Tokyo Women's Medical University Tokyo JapanDivision of Cardiology Saiseikai Kumamoto Hospital Kumamoto JapanHeart Rhythm Center Tokyo Medical and Dental University Tokyo JapanAbstract Background and purpose In expectation of better outcome of catheter ablation of atrial fibrillation (AF), several strategies of extra‐PV (pulmonary vein) substrate modification have been utilized. We assessed whether substrate modification or ablation of extra‐PV source is a predictor of complications. Methods Japanese Heart Rhythm Society requested electrophysiology centers to register the data of patients who underwent AF ablation. Results The data of 10 795 AF ablation cases (age; 63.8 ± 10.6 years) treated during 2011‐2016 were registered. Pericardial effusion (n = 105), massive bleeding (n = 108), stroke (n = 6), atrial‐esophageal fistula (n = 2), and other 114 complications occurred in 323 patients (3.0%). Univariate analysis revealed that age ≧ 65 years, female gender, heart failure, CHA2DS2‐VASc≧3, hemodialysis, deep sedation, and complex fractionated atrial electrogram (CFAE)‐guided ablation ([+] vs [−] = 4.3% vs 2.8%, P = .005) were related with the higher incidence of complications. Redo session, 3‐D imaging system ([+] vs [−]: 4.4% vs 2.9%, P = .017), and periprocedural dabigatran were related with the lower incidence of complications. None of the linear ablation of the left atrium, ganglionated plexi ablation, and superior vena cava ablation affected the incidence of complications. Multiple logistic regression analysis showed that in addition to 3‐D imaging system, age ≧ 65 years, redo session, and deep sedation, CFAE ablation was an independent predictor of the risk of complications (OR 1.78, P = .001). Specifically, implantation of a permanent pacemaker due to emerging sinus node dysfunction was frequent after CFAE ablation (CFAE [+] vs [−] = 4/1047 vs 2/9748, P < .001). Conclusions Among extra‐PV ablation strategies, CFAE‐guided ablation is a predictor of ablation‐related complications.https://doi.org/10.1002/joa3.12081atrial fibrillationcatheter ablationcomplex fractionated atrial electrogramcomplication |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuji Murakawa Teiichi Yamane Masahiko Goya Koichi Inoue Shigeto Naito Koichiro Kumagai Yasushi Miyauchi Norishige Morita Akihiko Nogami Morio Shoda Ken Okumura Kenzo Hirao on behalf of the Japanese Heart Rhythm Society Members |
spellingShingle |
Yuji Murakawa Teiichi Yamane Masahiko Goya Koichi Inoue Shigeto Naito Koichiro Kumagai Yasushi Miyauchi Norishige Morita Akihiko Nogami Morio Shoda Ken Okumura Kenzo Hirao on behalf of the Japanese Heart Rhythm Society Members Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016 Journal of Arrhythmia atrial fibrillation catheter ablation complex fractionated atrial electrogram complication |
author_facet |
Yuji Murakawa Teiichi Yamane Masahiko Goya Koichi Inoue Shigeto Naito Koichiro Kumagai Yasushi Miyauchi Norishige Morita Akihiko Nogami Morio Shoda Ken Okumura Kenzo Hirao on behalf of the Japanese Heart Rhythm Society Members |
author_sort |
Yuji Murakawa |
title |
Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016 |
title_short |
Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016 |
title_full |
Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016 |
title_fullStr |
Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016 |
title_full_unstemmed |
Influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: Analysis of 10 795 procedures in J‐CARAF Study 2011‐2016 |
title_sort |
influence of substrate modification in catheter ablation of atrial fibrillation on the incidence of acute complications: analysis of 10 795 procedures in j‐caraf study 2011‐2016 |
publisher |
Wiley |
series |
Journal of Arrhythmia |
issn |
1880-4276 1883-2148 |
publishDate |
2018-08-01 |
description |
Abstract Background and purpose In expectation of better outcome of catheter ablation of atrial fibrillation (AF), several strategies of extra‐PV (pulmonary vein) substrate modification have been utilized. We assessed whether substrate modification or ablation of extra‐PV source is a predictor of complications. Methods Japanese Heart Rhythm Society requested electrophysiology centers to register the data of patients who underwent AF ablation. Results The data of 10 795 AF ablation cases (age; 63.8 ± 10.6 years) treated during 2011‐2016 were registered. Pericardial effusion (n = 105), massive bleeding (n = 108), stroke (n = 6), atrial‐esophageal fistula (n = 2), and other 114 complications occurred in 323 patients (3.0%). Univariate analysis revealed that age ≧ 65 years, female gender, heart failure, CHA2DS2‐VASc≧3, hemodialysis, deep sedation, and complex fractionated atrial electrogram (CFAE)‐guided ablation ([+] vs [−] = 4.3% vs 2.8%, P = .005) were related with the higher incidence of complications. Redo session, 3‐D imaging system ([+] vs [−]: 4.4% vs 2.9%, P = .017), and periprocedural dabigatran were related with the lower incidence of complications. None of the linear ablation of the left atrium, ganglionated plexi ablation, and superior vena cava ablation affected the incidence of complications. Multiple logistic regression analysis showed that in addition to 3‐D imaging system, age ≧ 65 years, redo session, and deep sedation, CFAE ablation was an independent predictor of the risk of complications (OR 1.78, P = .001). Specifically, implantation of a permanent pacemaker due to emerging sinus node dysfunction was frequent after CFAE ablation (CFAE [+] vs [−] = 4/1047 vs 2/9748, P < .001). Conclusions Among extra‐PV ablation strategies, CFAE‐guided ablation is a predictor of ablation‐related complications. |
topic |
atrial fibrillation catheter ablation complex fractionated atrial electrogram complication |
url |
https://doi.org/10.1002/joa3.12081 |
work_keys_str_mv |
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