Treatment of atrial fibrillation by the ablation of localized sources: CONFIRM (Conventional Ablation for Atrial Fibrillation with or Without Focal Impulse and Rotor Modulation) trial

Journal of the American College of Cardiology

Volumn 60, Issue 7, 2012, Pages 628-636

  Narayan, Sanjiv M ^a,b   Krummen, David E ^a,b   Shivkumar, Kalyanam ^c   Clopton, Paul ^b   Rappel, Wouter Jan ^d   Miller, John M ^e  

^a UNIVERSITY OF CALIFORNIA SAN DIEGO   (United States)

^b VA SAN DIEGO HEALTHCARE SYSTEM   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

^d UNIVERSITY OF CALIFORNIA   (United States)

^e INDIANA UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

ablation; atrial fibrillation; electrical rotors; focal beats; multiwavelet reentry; therapy

Indexed keywords

AMIODARONE; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DOFETILIDE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; SOTALOL;

ADULT; ARTICLE; CATHETER ABLATION; CLINICAL STUDY; CLINICAL TRIAL; CONVENTIAL ABLATION FOR ATRIAL FIBRILLATION WITH OR WITHOUT FOCAL IMPULSE AND ROTOR MODULATION TRIAL; ELECTROCARDIOGRAPHY MONITORING; FEMALE; FOCAL IMPULSE AND ROTOR MODULATION ABLATION; HEART ATRIUM FIBRILLATION; HEART TAMPONADE; HUMAN; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PAROXYSMAL HEART ATRIUM FIBRILLATION; PERSISTENT HEART ATRIUM FIBRILLATION; PRIORITY JOURNAL; PROSPECTIVE STUDY; PULMONARY VEIN OBSTRUCTION;

AGED; ATRIAL FIBRILLATION; CATHETER ABLATION; DECISION MAKING, COMPUTER-ASSISTED; FEMALE; HEART CONDUCTION SYSTEM; HUMANS; MALE; MIDDLE AGED; MODELS, CARDIOVASCULAR; PROSPECTIVE STUDIES; TREATMENT OUTCOME;

EID: 84864722712     PISSN: 07351097     EISSN: 15583597     Source Type: Journal    
DOI: 10.1016/j.jacc.2012.05.022     Document Type: Article

References (36)

1. Y. Miyasaka, M.E. Barnes, B.J. Gersh Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence Circulation 114 2006 119 125
2. M. Haissaguerre, P. Jais, D.C. Shah Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins N Engl J Med 339 1998 659 666
3. H. Calkins, K.H. Kuck, R. Cappato 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design Heart Rhythm 9 2012 632 696
4. O.M. Wazni, N.F. Marrouche, D.O. Martin Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial JAMA 293 2005 2634 2640
5. H. Oral, C. Pappone, A. Chugh Circumferential pulmonary-vein ablation for chronic atrial fibrillation N Engl J Med 354 2006 934 941
6. D.J. Wilber, C. Pappone, P. Neuzil Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial JAMA 303 2010 333 340
7. Verma A, Champagne J, Sapp J, et al. Discerning the incidence of symptomatic and asymptomatic episodes of atrial fibrillation pre- and post-radiofrequency ablation (DISCERN AF): a prospective, multicenter study (late breaking clinical trial abstract LB-02). Paper presented at: Heart Rhythm Society 2011 Scientific Sessions; May 5, 2011; San Francisco, CA.
8. A. Cheema, C.R. Vasamreddy, D. Dalal Long-term single procedure efficacy of catheter ablation of atrial fibrillation J Interv Card Electrophysiol 15 2006 145 155
9. R. Weerasooriya, P. Khairy, J. Litalien Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? J Am Coll Cardiol 57 2011 160 166
10. M. Haissaguerre, P. Sanders, M. Hocini Catheter ablation of long-lasting persistent atrial fibrillation: critical structures for termination J Cardiovasc Electrophysiol 16 2005 1125 1137
11. F. Ouyang, M. Antz, S. Ernst Recovered pulmonary vein conduction as a dominant factor for recurrent atrial tachyarrhythmias after complete circular isolation of the pulmonary veins: lessons from double lasso technique Circulation 111 2005 127 135
12. A. Verma, F. Kilicaslan, E. Pisano Response of atrial fibrillation to pulmonary vein antrum isolation is directly related to resumption and delay of pulmonary vein conduction Circulation 112 2005 627 635
13. N. Sawhney, K. Anand, C.E. Robertson, T. Wurdeman, R. Anousheh, G.K. Feld Recovery of mitral isthmus conduction leads to the development of macro-reentrant tachycardia after left atrial linear ablation for atrial fibrillation Circ Arrhythm Electrophysiol 4 2011 832 837
14. S. Nattel New ideas about atrial fibrillation 50 years on Nature 415 2002 219 226
15. M.A. Allessie, N.M. de Groot, R.P. Houben The electropathological substrate of longstanding persistent atrial fibrillation in patients with structural heart disease: longitudinal dissociation Circ Arrhythm Electrophysiol 3 2010 606 615
16. M. Vaquero, D. Calvo, J. Jalife Cardiac fibrillation: from ion channels to rotors in the human heart Heart Rhythm 5 2008 872 879
17. S. Lazar, S. Dixit, F.E. Marchlinski, D.J. Callans, E.P. Gerstenfeld Presence of left-to-right atrial frequency gradient in paroxysmal but not persistent atrial fibrillation in humans Circulation 110 2004 3181 3186
18. J. Sahadevan, K. Ryu, L. Peltz Epicardial mapping of chronic atrial fibrillation in patients: preliminary observations Circulation 110 2004 3293 3299
19. W.P. Beukema, H.T. Sie, A.R. Misier, P.P. Delnoy, H.J. Wellens, A. Elvan Predictive factors of sustained sinus rhythm and recurrent atrial fibrillation after a radiofrequency modified Maze procedure Eur J Cardiothorac Surg 34 2008 771 775
20. A.C. Skanes, R. Mandapati, O. Berenfeld, J.M. Davidenko, J. Jalife Spatiotemporal periodicity during atrial fibrillation in the isolated sheep heart Circulation 98 1998 1236 1248
21. P.S. Cuculich, Y. Wang, B.D. Lindsay Noninvasive characterization of epicardial activation in humans with diverse atrial fibrillation patterns Circulation 122 2010 1364 1372
22. F. Atienza, D. Calvo, J. Almendral Mechanisms of fractionated electrograms formation in the posterior left atrium during paroxysmal atrial fibrillation in humans J Am Coll Cardiol 57 2011 1081 1092
23. S.M. Narayan, D.E. Krummen, W.-J. Rappel Clinical mapping approach to diagnose electrical rotors and focal impulse sources for human atrial fibrillation J Cardiovasc Electrophysiol 23 2012 447 454
24. S.M. Narayan, D. Kazi, D.E. Krummen, W.-J. Rappel Repolarization and activation restitution near human pulmonary veins and atrial fibrillation initiation: a mechanism for the initiation of atrial fibrillation by premature beats J Am Coll Cardiol 52 2008 1222 1230
25. S.M. Narayan, M.R. Franz, P. Clopton, E.J. Pruvot, D.E. Krummen Repolarization alternans reveals vulnerability to human atrial fibrillation Circulation 123 2011 2922 2930
26. G. Lalani, A. Schricker, M. Gibson, A. Rostamanian, D.E. Krummen, S.M. Narayan Dynamic conduction slowing precedes human atrial fibrillation initiation: insights from bi-atrial basket mapping on transitions to atrial fibrillation J Am Coll Cardiol 59 2012 595 606
27. P. Ziegler, J. Koehler, R. Mehra Comparison of continuous versus intermittent monitoring of atrial arrhythmias Heart Rhythm 3 2006 1445 1452
28. Y. Takahashi, M.D. O'Neill, M. Hocini Characterization of electrograms associated with termination of chronic atrial fibrillation by catheter ablation J Am Coll Cardiol 51 2008 1003 1010
29. Y.J. Lin, C.T. Tai, T. Kao Electrophysiological characteristics and catheter ablation in patients with paroxysmal right atrial fibrillation Circulation 112 2005 1692 1700
30. T.J. Wu, R.N. Doshi, H.L.A. Huang Simultaneous biatrial computerized mapping during permanent atrial fibrillation in patients with organic heart disease J Cardiovasc Electrophysiol 13 2002 571 577
31. P. Sanders, O. Berenfeld, M. Hocini Spectral analysis identifies sites of high-frequency activity maintaining atrial fibrillation in humans Circulation 112 2005 789 797
32. K. Nademanee, J. McKenzie, E. Kosar A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate J Am Coll Cardiol 43 2004 2044 2053
33. S.M. Narayan, J. Patel, S. Mulpuru, D.E. Krummen Focal impulse and rotor modulation (FIRM) ablation of sustaining rotors abruptly terminates persistent atrial fibrillation to sinus rhythm with elimination on follow-up Heart Rhythm 2012 In press
34. R.S. Oakes, T.J. Badger, E.G. Kholmovski Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation Circulation 119 2009 1758 1767
35. X. Sheng, B.J. Scherlag, L. Yu Prevention and reversal of atrial fibrillation inducibility and autonomic remodeling by low-level vagosympathetic nerve stimulation J Am Coll Cardiol 57 2011 563 571
36. M. Hocini, I. Nault, M. Wright Disparate evolution of right and left atrial rate during ablation of long-lasting persistent atrial fibrillation J Am Coll Cardiol 55 2010 1007 1016