Abstract 13948: High Intraprocedural Atrial Fibrillation Termination Rate by Large Area Rotor Ablation Combined With Pulmonary Vein Isolation
Introduction: There remains contradictory data about the optimal ablation technique and the type of termination of atrial fibrillation (AF) ablation particularly in patient (pt) with persistent AF. The aim of this study was to determine the type of the termination of persistent AF during combined conventional and rotor ablation.
Method: This is a single-center, prospective, observational study enrolled thirty-eight pts (24/63% male, mean age 63 years) with AF (mean left atrial size: 46,2 ± 7 mm), who underwent focal impulse and rotor modulation (FIRM) mapping and large area ablation around the core of the identified rotor(s), followed by conventional pulmonary vein isolation(PVI) using contact force catheter aiming 10-20 gr depending on the location. Two distinctive types of the AF termination were defined: sub-acute termination related to rotor elimination, furthermore acute termination due to PVI. Electric cardioversion (ECV) was executed only in the absence of spontaneous conversion to sinus rhythm (SR).
Result: In 10(26%) pts acute AF termination after PVI was observed. In further 12 (31%) pts sub-acute termination of the AF could be observed after the identified rotor ablation. The combined technique of conventional and rotor ablation of pts with persistent AF resulted in 57,8% of termination rate. Spontaneous cardioversion could not be reached in 16 (42%) pts however 15 out of them were converted to SR by ECV. Procedural complication occurred in 3 pts presenting with groin hematoma, in one patient left atrial appendage (LAA) thrombus was revealed by transoesophageal echocardiography performed right after the ablation for guiding the planned LAA closure.
Conclusion: Large area rotor ablation drag technique combined with contact force sensing technique results in a high termination rate of persistent AF. More studies are warranted to define the clinical significance and long term success rate of rotor ablation in pts with persistent atrial fibrillation.
Author Disclosures: Z. Kis: None. R. Bhagwandien: None. D. Theuns: None. S. Wijchers: None. T. Szili-Torok: None.
- © 2016 by American Heart Association, Inc.