作者
Atul Verma, Chen-yang Jiang, Timothy R Betts, Jian Chen, Isabel Deisenhofer, Roberto Mantovan, Laurent Macle, Carlos A Morillo, Wilhelm Haverkamp, Rukshen Weerasooriya, Jean-Paul Albenque, Stefano Nardi, Endrj Menardi, Paul Novak, Prashanthan Sanders
发表日期
2015/5/7
期刊
New England Journal of Medicine
卷号
372
期号
19
页码范围
1812-1822
出版商
Massachusetts Medical Society
简介
Background
Catheter ablation is less successful for persistent atrial fibrillation than for paroxysmal atrial fibrillation. Guidelines suggest that adjuvant substrate modification in addition to pulmonary-vein isolation is required in persistent atrial fibrillation.
Methods
We randomly assigned 589 patients with persistent atrial fibrillation in a 1:4:4 ratio to ablation with pulmonary-vein isolation alone (67 patients), pulmonary-vein isolation plus ablation of electrograms showing complex fractionated activity (263 patients), or pulmonary-vein isolation plus additional linear ablation across the left atrial roof and mitral valve isthmus (259 patients). The duration of follow-up was 18 months. The primary end point was freedom from any documented recurrence of atrial fibrillation lasting longer than 30 seconds after a single ablation procedure.
Results
Procedure time was significantly shorter for pulmonary-vein isolation alone than for …
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A Verma, C Jiang, TR Betts, J Chen, I Deisenhofer… - New England Journal of Medicine, 2015