Is Circumferential Pulmonary Vein Isolation Preferable to Stepwise Segmental Pulmonary Vein Isolation for Patients With Paroxysmal Atrial Fibrillation? A Randomized Study

DOI Web Site 被引用文献1件 参考文献31件
  • Liu Xingpeng
    The first two authors contributed equally
  • Long Deyong
    The first two authors contributed equally
  • Dong Jianzeng
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Hu Fuli
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Yu Ronghui
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Tang Ribo
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Fang Dongping
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Hao Peng
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Lu Chunshan
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Liu Xiaoqing
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • He Xiaokui
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Liu Xiaohui
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences
  • Ma Changsheng
    Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences

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タイトル別名
  • A Randomized Study

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Background Stepwise segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) have been developed to treat patients with atrial fibrillation (AF), but the preferable approach for paroxysmal AF (PAF) has not been established. Methods and Results One hundred and ten patients with symptomatic PAF were randomized into a stepwise SPVI group (n=55) or CPVI group (n=55). Systemic SPVI combined with left atrial linear ablation tailored by inducibility of AF was performed in the stepwise SPVI group. Circumferential linear ablation around the left and right-sided pulmonary veins (PVs) guided by 3-dimensional electroanatomic mapping was performed in the CPVI group. The endpoints of ablation are non-induciblity of AF in the stepwise SPVI group and continuity of circular lesions combined with PV isolation in the CPVI group. After the initial procedures, atrial tachyarrhythmis (ATa) recurred within the first 3 months in 23 of the 55 patients (41.8%) who underwent stepwise SPVI and in 20 of the 55 patients (36.4%) who had CPVI (p=0.69). Repeat procedures were performed in 7 patients from the stepwise SPVI group and 5 from the CPVI group (p=0.76). During the 3-9 months after the last procedure, 46 patients (83.6%) from the CPVI group and 43 (78.2%) from the stepwise SPVI group did not have symptomatic ATa while not taking anti-arrhythmic drugs (p=0.63). Severe subcutaneous hematoma or PV stenosis occurred in 3 patients. Conclusions The efficacy of stepwise SPVI is comparable to that of CPVI for patients with PAF. (Circ J 2006; 70: 1392 - 1397)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 70 (11), 1392-1397, 2006

    一般社団法人 日本循環器学会

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