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

doi:10.1016/j.hroo.2022.04.003

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

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

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 language	English
Pages (from-to)	269-278
Number of pages	10
Journal	Heart Rhythm O2
Volume	3
Issue number	3
DOIs	https://doi.org/10.1016/j.hroo.2022.04.003
State	Published - Jun 2022

Keywords

Ablation
CARTOFINDER
Long-standing persistent atrial fibrillation
Outcome
Substrate modification

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10.1016/j.hroo.2022.04.003

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Chang, T. Y., Lin, C. Y., Lin, Y. J., Wu, C. I., Chang, S. L., Lo, L. W., Hu, Y. F., Chung, F. P., Tuan, T. C., Chao, T. F., Liao, J. N., Kuo, L., Liu, C. M., & Chen, S. A. (2022). 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. Heart Rhythm O2, 3(3), 269-278. https://doi.org/10.1016/j.hroo.2022.04.003

@article{e30b282c5a4a4a7aac5543705cdbe31a,

title = "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",

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.",

keywords = "Ablation, CARTOFINDER, Long-standing persistent atrial fibrillation, Outcome, Substrate modification",

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

note = "Publisher Copyright: {\textcopyright} 2022 Heart Rhythm Society",

year = "2022",

month = jun,

doi = "10.1016/j.hroo.2022.04.003",

language = "English",

volume = "3",

pages = "269--278",

journal = "Heart Rhythm O2",

issn = "2666-5018",

publisher = "Elsevier Inc.",

number = "3",

}

Chang, TY, Lin, CY, Lin, YJ, Wu, CI, Chang, SL , Lo, LW , Hu, YF, Chung, FP, Tuan, TC, Chao, TF, Liao, JN, Kuo, L, Liu, CM & Chen, SA 2022, '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', Heart Rhythm O2, vol. 3, no. 3, pp. 269-278. https://doi.org/10.1016/j.hroo.2022.04.003

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. / Chang, Ting Yung; Lin, Chin Yu; Lin, Yenn Jiang et al.
In: Heart Rhythm O2, Vol. 3, No. 3, 06.2022, p. 269-278.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Long-term outcome of patients with long-standing persistent atrial fibrillation undergoing ablation guided by a novel high-density panoramic mapping system

T2 - A propensity score matching study

AU - Chang, Ting Yung

AU - Lin, Chin Yu

AU - Lin, Yenn Jiang

AU - Wu, Cheng I.

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Chung, Fa Po

AU - Tuan, Ta Chuan

AU - Chao, Tze Fan

AU - Liao, Jo Nan

AU - Kuo, Ling

AU - Liu, Chih Min

AU - Chen, Shih Ann

PY - 2022/6

Y1 - 2022/6

N2 - 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.

AB - 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.

KW - Ablation

KW - CARTOFINDER

KW - Long-standing persistent atrial fibrillation

KW - Outcome

KW - Substrate modification

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U2 - 10.1016/j.hroo.2022.04.003

DO - 10.1016/j.hroo.2022.04.003

M3 - Article

AN - SCOPUS:85131441188

SN - 2666-5018

VL - 3

SP - 269

EP - 278

JO - Heart Rhythm O2

JF - Heart Rhythm O2

IS - 3

ER -

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

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