Long-term outcome of patients with long-standing persistent atrial fibrillation undergoing ablation guided by a novel high-density panoramic mapping system: A propensity score matching study

Ting Yung Chang, Chin Yu Lin, Yenn Jiang Lin*, Cheng I. Wu, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Fa Po Chung, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Ling Kuo, Chih Min Liu, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Catheter ablation is a current therapeutic approach for atrial fibrillation (AF). However, its efficacy for long-standing persistent AF remains suboptimal. Objective: The purpose of this study was to test the hypothesis that a panoramic mapping system (CARTOFINDER, Biosense Webster) can guide pulmonary vein (PV) isolation and additional potential AF drivers. Methods: A total of 76 patients with nonparoxysmal AF referred for ablation guided by a novel high-density panoramic mapping system with CARTOFINDER were prospectively enrolled. Of this cohort, 40 patients (52.6%) had long-standing persistent AF (CARTOFINDER group). We then retrospectively screened the patients with long-standing persistent AF undergoing conventional PV isolation and elimination of non-PV triggers during the contemporary period (conventional group). They were matched at a 1:2 ratio (40 patients in group 1 received ablation guided by CARTOFINDER; 80 patients in group 2 receiving conventional PV isolation and elimination of non-PV triggers). Results: During follow-up, patients in group 1 had a lower recurrence AF rate than those in group 2 (P = .040). There was no difference in recurrence of atrial flutter (P = .996) and atrial tachycardia (P = .525). In Cox proportional hazards regression analysis, AF duration and PV isolation along with AF driver ablation using a panoramic mapping system with CARTOFINDER both were independent predictors of recurrent AF after catheter ablation of long-standing persistent AF. Conclusion: Identification of the potential drivers in long-standing AF is crucial. Compared with conventional PV isolation and elimination of non-PV triggers, ablation guided by a high-density panoramic mapping system (CARTOFINDER) might have a better outcome in patients with long-standing persistent AF.

Original languageEnglish
Pages (from-to)269-278
Number of pages10
JournalHeart Rhythm O2
Volume3
Issue number3
DOIs
StatePublished - Jun 2022

Keywords

  • Ablation
  • CARTOFINDER
  • Long-standing persistent atrial fibrillation
  • Outcome
  • Substrate modification

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