부산대학교 도서관

Background: The outcomes of pulmonary vein isolation (PVI) for persistent atrial fibrillation (AF) are suboptimal. The entire pulmonary venous component (PV‐Comp), consisting of the pulmonary veins, their antra, and the area between the antra, provides triggers and substrate for AF. PV‐Comp isolation is an alternative strategy for persistent AF ablation. Methods: Among 328 patients with persistent AF who underwent a first radiofrequency ablation procedure, 200 patients (PVI, n = 100; PV‐Comp isolation, n = 100) were selected by propensity score matching. Both groups were followed up for 1 year. Results: At 6‐ and 12‐month follow‐up, atrial tachyarrhythmia (AF/atrial tachycardia) recurred in 41 and 61 patients in PVI group and 22 (P =.006) and 33 patients (P <.001) in PV‐Comp isolation group, respectively. PV‐Comp isolation was associated with longer mean time to recurrence (PVI: 8 months, PV‐Comp isolation: 10 months, log‐rank P <.001) and a lower probability of recurrence (odds ratio [OR] = 0.32; 95% confidence of interval [CI] = 0.18‐0.56, P <.001), with no increase in procedural complications (PVI: 5 of 100, PV‐Comp isolation: 6 of 100, P =.76). Procedure duration was longer in PV‐Comp isolation group (PVI: 186 ± 42 min, PV‐Comp isolation: 238 ± 44 min, P <.001), as well as fluoroscopy time (PVI: 22 ± 16 min, PV‐Comp isolation: 31 ± 21 min, P =.001). Conclusion: PV‐Comp isolation for persistent AF reduced atrial tachyarrhythmia recurrence up to 1 year compared with PVI alone. While procedure and fluoroscopy time increased, there was no difference in procedural complications. [ABSTRACT FROM AUTHOR]