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Acute response and rhythm outcome after the patchy late-gadolinium enhancement site catheter ablation in patients with persistent atrial fibrillation
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  • kunihiko kiuchi,
  • Koji Fukuzawa,
  • Mitsuru Takami,
  • yoshiaki watanabe,
  • Yu Izawa,
  • Mayumi Shigeru,
  • hiroyuki oonishi,
  • hideya suehiro,
  • tomomi akita,
  • makoto takemoto,
  • atsusuke yatomi,
  • Toshihiro Nakamura,
  • jun sakai,
  • Kazutaka Nakasone,
  • Yusuke Sonoda,
  • Kyoko Yamamoto,
  • Hiroyuki Takahara,
  • noriyuki negi,
  • katsusuke kyotani,
  • Atsushi Kono,
  • Ken-ichi Hirata
kunihiko kiuchi
Kobe University Graduate School of Medicine
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Koji Fukuzawa
Kobe University Graduate School of Medicine
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Mitsuru Takami
Kobe University Graduate School of Medicine
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yoshiaki watanabe
Kobe University Graduate School of Medicine
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Yu Izawa
Kobe University Graduate School of Medicine
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Mayumi Shigeru
Kobe University Graduate School of Medicine
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hiroyuki oonishi
Kobe Circulation Clinic
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hideya suehiro
Kobe University Graduate School of Medicine
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tomomi akita
Kobe University Graduate School of Medicine
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makoto takemoto
Kobe University Graduate School of Medicine
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atsusuke yatomi
Kobe University Graduate School of Medicine
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Toshihiro Nakamura
Kobe University
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jun sakai
Kobe University Graduate School of Medicine
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Kazutaka Nakasone
Kobe University Graduate School of Medicine
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Yusuke Sonoda
Kobe University Graduate School of Medicine
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Kyoko Yamamoto
Kobe University Graduate School of Medicine
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Hiroyuki Takahara
Kobe University Graduate School of Medicine
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noriyuki negi
Kobe University Hospital
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katsusuke kyotani
KOBE UNIVERSITY HOSPITAL
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Atsushi Kono
Kobe University Graduate School of Medicine
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Ken-ichi Hirata
Kobe University Graduate School of Medicine
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Abstract

Background: Computer simulation model demonstrated that atrial fibrillation (AF) driver attached to the patchy fibrosis assessed by late gadolinium enhancement magnetic resonance imaging (LGE-MRI). However, it has not been well elucidated in patients with persistent AF. The aim of this study is to investigate whether radiofrequency (RF) application on the patchy LGE site (PLS) could terminate AF or convert to atrial tachycardia (AT) and improve the rhythm outcome. Methods: A total of 31consecutive persistent AF patients with PLS were enrolled (PLS ablation group, mean age: 69 ± 8 years, mean left atrial diameter: 42 ± 6 mm). AF direct termination or AT conversion during RF application on the PLS were defined as favorable response. The rhythm outcome was compared between the PLS ablation group and the propensity matched conventional ablation group. Results: Favorable response was found in 15 (48%) of 31 patients (AF termination in 7, AT conversion in 8 patients). AF recurrence at 12 months follow-up was significantly less in the PLS group as compared to the control group (4 (13%) of 31 patients vs. 11 (35%) of 31 patients, log-rank p = 0.019). In patients with favorable response, AT recurred in 1 (7%) of 15 patients but AF. Conclusions: The PLS ablation could terminate AF or convert to AT in half of the patients and improve the rhythm outcome as compared to the conventional ablation. No AF recurrence was documented in patients with a favorable response.

Peer review status:ACCEPTED

29 Oct 2020Submitted to Journal of Cardiovascular Electrophysiology
30 Oct 2020Submission Checks Completed
30 Oct 2020Assigned to Editor
31 Oct 2020Reviewer(s) Assigned
09 Nov 2020Review(s) Completed, Editorial Evaluation Pending
16 Nov 2020Editorial Decision: Revise Minor
18 Nov 20201st Revision Received
22 Nov 2020Assigned to Editor
22 Nov 2020Submission Checks Completed
22 Nov 2020Reviewer(s) Assigned
02 Dec 2020Review(s) Completed, Editorial Evaluation Pending
07 Dec 2020Editorial Decision: Revise Minor
09 Dec 20202nd Revision Received
09 Dec 2020Submission Checks Completed
09 Dec 2020Assigned to Editor
09 Dec 2020Reviewer(s) Assigned
10 Jan 2021Review(s) Completed, Editorial Evaluation Pending
11 Jan 2021Editorial Decision: Accept