Clinical Usefulness of Virtual Ablation Guided Catheter Ablation of Atrial Fibrillation Targeting Restitution Parameter-Guided Catheter Ablation: CUVIA-REGAB Prospective Randomized Studyopen access
- Authors
- Choi, Young; Lim, Byounghyun; Yang, Song-Yi; Yang, So-Hyun; Kwon, Oh-Seok; Kim, Daehoon; Kim, Yun Gi; Park, Je-Wook; Yu, Hee Tae; Kim, Tae-Hoon; Yang, Pil-Sung; Uhm, Jae -Sun; Shim, Jamin; Kim, Sung Hwan; Sung, Jung-Hoon; Choi, Jong-il; Joung, Boyoung; Lee, Moon-Hyoung; Kim, Young-Hoon; Oh, Yong-Seog; Pak, Hui-Nam; CUVIA-REGAB Investigators
- Issue Date
- 9월-2022
- Publisher
- KOREAN SOC CARDIOLOGY
- Keywords
- Catheter ablation; Computer simulation; Action potential; Electrophysiology; Atrial fibrillation
- Citation
- KOREAN CIRCULATION JOURNAL, v.52, no.9, pp.699 - 711
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN CIRCULATION JOURNAL
- Volume
- 52
- Number
- 9
- Start Page
- 699
- End Page
- 711
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/145777
- DOI
- 10.4070/kcj.2022.0113
- ISSN
- 1738-5520
- Abstract
- Background and Objectives: We investigated whether extra-pulmonary vein (PV) ablation targeting a high maximal slope of the action potential duration restitution curve (Smax) improves the rhythm outcome of persistent atrial fibrillation (PeAF) ablation. Methods: In this open-label, multi-center, randomized, and controlled trial, 178 PeAF patients were randomized with 1:1 ratio to computational modeling-guided virtual Smax ablation (V-Smax) or empirical ablation (E-ABL) groups. Smax maps were generated by computational modeling based on atrial substrate maps acquired during clinical procedures in sinus rhythm. Smax maps were generated during the clinical PV isolation (PVI). The V-Smax group underwent an additional extra-PV ablation after PVI targeting the virtual high Smax sites. Results: After a mean follow-up period of 12.3 +/- 5.2 months, the clinical recurrence rates (25.6% vs. 23.9% in the V-Smax and the E-ABL group, p=0.880) or recurrence appearing as atrial tachycardia (11.1% vs. 5.7%, p=0.169) did not differ between the 2 groups. The post -ablation cardioversion rate was higher in the V-Smax group than E-ABL group (14.4% vs. 5.7%, p=0.027). Among antiarrhythmic drug-free patients (n=129), the AF freedom rate was 78.7% in the V-Smax group and 80.9% in the E-ABL group (p=0.776). The total procedure time was longer in the V-Smax group (p=0.008), but no significant difference was found in the major complication rates (p=0.497) between the groups. Conclusions: Unlike a dominant frequency ablation, the computational modeling-guided V-Smax ablation did not improve the rhythm outcome of the PeAF ablation and had a longer procedure time.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.