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- W2469757242 abstract "Introduction: Pulmonary vein (PV) to left atrial (LA) reconnection is implicated in AF recurrence. We hypothesised that ablation of critical PV-LA connections may improve AF-free survival. Methods: 207 PAF patients underwent circumferential antral PVI. Lesions causing loss of local PV signals, reversal of PV electrogram polarity, activation change, PV-LA delay, or PV isolation were tagged as ‘critical sites’. After PVI + anatomic encirclement the procedure was either stopped (standard group, n=127) or additional RF given at pre-identified critical sites (consolidation group, n=80). On repeat procedures, sites of chronic PV reconnection were correlated with critical sites identified during the index procedure. Results: Baseline clinical characteristics were similar in the standard vs. consolidation groups (P=NS). RF time was significantly longer in the consolidation group (61±15 vs. 53±12 mins, P<.001). Single, procedure success rate was significantly greater in the consolidation vs. standard group at 1 year (95% vs. 79%, P=.003) and 2 years (92% vs. 70%). In patients from the standard group who underwent a redo procedure for AF recurrence, sites of chronic PV reconnection almost always occurred (86% of PVs) at those sites deemed ‘critical’ from the index procedure. Conclusions: Examining the response of PV signals to antral ablation allows identification of PV-LA connections that may play a critical role in future PV reconnection and AF recurrence. Additional ablation at these critical sites in addition to PVI markedly improves AF-free survival compared to standard PVI alone." @default.
- W2469757242 created "2016-07-22" @default.
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- W2469757242 date "2015-01-01" @default.
- W2469757242 modified "2023-09-26" @default.
- W2469757242 title "Consolidating lesions at sites of critical pulmonary-vein left atrial connections in addition to PVI significantly improves AF-free survival compared to PVI alone" @default.
- W2469757242 doi "https://doi.org/10.1016/j.hlc.2015.06.300" @default.
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