Adjunctive Right Atrial Ablation for Persistent Atrial Fibrillation With Right Atrial Enlargement

Study Overview
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Brief Summary
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This is retrospective cohort study testing whether patients with persistent atrial fibrillation and right atrial enlargement may benefit from adjunctive right atrial ablation.

Detailed Description
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This is retrospective cohort study testing whether patients with persistent atrial fibrillation and right atrial enlargement may benefit from adjunctive RA ablation. We enrolled 65 patients with persistent atrial fibrillation and right atrial enlargement received adjunctive right atrial ablation. These patients were 1:2 match with 130 patients received left atrial ablation only. Atrial fibrillation recurrence rate and other paremeters were analyzed to evaluate the efficacy of adjunctive right atrial ablation in this subset of patients.

Official Title
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Adjunctive Right Atrial Ablation for Persistent Atrial Fibrillation With Right Atrial Enlargement

Conditions
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Persistent Atrial Fibrillation, Right Atrial Enlargement

Intervention / Treatment
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* Procedure: Circumferential pulmonary vein isolation + linear ablation + bi-atrial mapping + left atrial driver ablation
* Procedure: Circumferential pulmonary vein isolation + linear ablation + bi-atrial mapping + left atrial driver ablation + right atrial driver ablation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 to 80 years old; Persistent AF with right atrial enlargement; Nonresponse or intolerance to ≥1 antiarrhythmic drug. Exclusion Criteria: History of catheter ablation; valvular heart disease; hypertrophic cardiomyopathy or dilated cardiomyopathy; Without follow-up data

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| LA + RA ablation<br>Patients with persistent atrial fibrillation and right atrial enlargement received adjunctive right atrial ablation when left atrial ablation did not terminate atrial fibrillation. | Procedure: Circumferential pulmonary vein isolation + linear ablation + bi-atrial mapping + left atrial driver ablation + right atrial driver ablation<br>* Patients receive circumferential pulmonary vein isolation and linear ablation (ablation of a roof line and a mitral isthmus line) combined with bi-atrial mapping , left atrial driver ablation and right atrial driver ablation.<br>|
| LA ablation only<br>Patients with persistent atrial fibrillation and right atrial enlargement received left atrial ablation only | Procedure: Circumferential pulmonary vein isolation + linear ablation + bi-atrial mapping + left atrial driver ablation<br>* Patients receive circumferential pulmonary vein isolation and linear ablation (ablation of a roof line and a mitral isthmus line) combined with bi-atrial mapping and left atrial driver ablation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| atrial fibrillation (AF) recurrence rate | AF recurrence is defined as presence of documented AF episodes of 30 seconds or longer duration | at 12 months post procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| atrial fibrillation (AF)/atrial flutter (AFL)/atrial tachycardia (AT) recurrence rate | AF/AFL/AT recurrence is defined as presence of documented AF/AFL/AT episodes of 30 seconds or longer duration | at 12 months post procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Atrial fibrillation, Right atrium