医学
心房颤动
内科学
心脏病学
烧蚀
利钠肽
导管消融
相伴的
射频消融术
心力衰竭
作者
Mihoko Kawabata,Masahiko Goya,Takamitsu Takagi,Shu Yamashita,Shinsuke Iwai,Masahito Suzuki,Takeshi Tomomasa,Tomofumi Nakamura,Tatsuya Hayashi,Atsuhiko Yagishita,Takeshi Sasaki,Yoshihide Takahashi,Yuhichi Ono,Hitoshi Hishida,Yasuteru Yamauchi,Kenichiro Otomo,Junichi Nitta,Kaoru Okishige,Mitsuhiro Nishizaki,Yoshito Iesaka,Mitsuaki Isobe,Kazuyuki Hirao
标识
DOI:10.1016/j.jjcc.2016.01.007
摘要
Atrial fibrillation (AF) often coexists with Wolff-Parkinson-White (WPW) syndrome. We compared the efficacy of Kent bundle ablation alone and additional AF ablation on accompanying AF, and examined which patients would still have a risk of AF after successful Kent bundle ablation.This retrospective multicenter study included 96 patients (56±15 years, 72 male) with WPW syndrome and AF undergoing Kent bundle ablation. Some patients underwent simultaneous pulmonary vein isolation (PVI) for AF. The incidence of post-procedural AF was examined.Sixty-four patients underwent only Kent bundle ablation (Kent-only group) and 32 also underwent PVI (+PVI group). There was no significant difference in the basic patient characteristics between the groups. Additional PVI did not improve the freedom from residual AF compared to Kent bundle ablation alone (p=0.53). In the Kent-only group, AF episodes remained in 25.0% during the follow-up (709 days). A univariate analysis showed that age ≥60 years, left atrial dimension ≥38mm, B-type natriuretic peptide (BNP) ≥40pg/ml, and concomitant hypertension were predictive factors for residual AF. However, in the multivariate analysis, only BNP ≥40pg/ml remained as an independent predictive factor (HR=17.1 and CI: 2.3-128.2; p=0.006).Among patients with WPW syndrome and AF, Kent bundle ablation alone may have a sufficient clinical impact of preventing recurrence of AF in select patients. Screening the BNP level would help decide the strategy to manage those patients.
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