PMID- 35775822
OWN - NLM
STAT- MEDLINE
DCOM- 20221013
LR  - 20221229
IS  - 1540-8167 (Electronic)
IS  - 1045-3873 (Print)
IS  - 1045-3873 (Linking)
VI  - 33
IP  - 10
DP  - 2022 Oct
TI  - Coronary sinus electrogram characteristics predict termination of AF with 
      ablation and long-term clinical outcome.
PG  - 2139-2151
LID - 10.1111/jce.15618 [doi]
AB  - INTRODUCTION: Markers predicting atrial fibrillation (AF) termination and freedom 
      from AF/atrial tachycardia (AT) has been proposed. This study aimed to evaluate 
      the role of novel coronary sinus (CS) electrogram characteristics in predicting 
      the acute ablation response and freedom from AF/AT during follow-up. METHODS: 
      Patients undergoing ablation for persistent AF as part of the Stochastic 
      Trajectory Analysis of Ranked signals mapping study were included. Novel CS 
      electrogram characteristics including CS cycle length variability (CLV) and CS 
      activation pattern stability (APS) and proportion of low voltage zones (LVZs) 
      were reviewed as potential predictors for AF termination on ablation and freedom 
      from AF/AT during follow-up. The relationship between localized driver 
      characteristics and CS electrogram characteristics was also assessed. RESULTS: 
      Sixty-five patients were included. AF termination was achieved in 51 patients and 
      80% of patients were free from AF/AT during a follow-up of 29.5 +/- 3.7 months. CS 
      CLV of <30 ms, CS APS of >/=30% and proportion of LVZ < 30% showed high diagnostic 
      accuracy in predicting AF termination on ablation and freedom from AF/AT during 
      follow-up (CS CLV odds ratio [OR] 25.6, area under the curve [AUC] 0.91; CS APS 
      OR 15.9, AUC 0.94; proportion of LVZs OR 21.4, AUC 0.88). These markers were 
      independent predictors of AF termination on ablation and AF/AT recurrence during 
      follow-up. Ablation of a smaller number of drivers that demonstrate greater 
      dominance strongly correlate with greater CS organization. CONCLUSION: Novel CS 
      electrogram characteristics were independent predictors of AF termination and 
      AF/AT recurrence during follow-up. These markers can potentially aid in 
      predicting outcomes and guide ablation and follow-up strategies.
CI  - (c) 2022 The Authors. Journal of Cardiovascular Electrophysiology published by 
      Wiley Periodicals LLC.
FAU - Honarbakhsh, Shohreh
AU  - Honarbakhsh S
AUID- ORCID: 0000-0003-0081-5739
AD  - The Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, 
      London, UK.
FAU - Schilling, Richard J
AU  - Schilling RJ
AD  - The Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, 
      London, UK.
FAU - Keating, Emily
AU  - Keating E
AD  - The Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, 
      London, UK.
FAU - Finlay, Malcolm
AU  - Finlay M
AD  - The Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, 
      London, UK.
FAU - Hunter, Ross J
AU  - Hunter RJ
AD  - The Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, 
      London, UK.
LA  - eng
GR  - PG/16/10/32016/BHF_/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220728
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
MH  - *Atrial Fibrillation/diagnosis/surgery
MH  - *Catheter Ablation/adverse effects
MH  - *Coronary Sinus/surgery
MH  - Humans
MH  - *Pulmonary Veins/surgery
MH  - Recurrence
MH  - *Tachycardia, Supraventricular
MH  - Treatment Outcome
PMC - PMC9796101
OTO - NOTNLM
OT  - atrial fibrillation
OT  - catheter ablation
OT  - coronary sinus
OT  - drivers
OT  - mapping
EDAT- 2022/07/02 06:00
MHDA- 2022/10/14 06:00
PMCR- 2022/12/28
CRDT- 2022/07/01 08:33
PHST- 2022/05/10 00:00 [revised]
PHST- 2022/02/18 00:00 [received]
PHST- 2022/06/29 00:00 [accepted]
PHST- 2022/07/02 06:00 [pubmed]
PHST- 2022/10/14 06:00 [medline]
PHST- 2022/07/01 08:33 [entrez]
PHST- 2022/12/28 00:00 [pmc-release]
AID - JCE15618 [pii]
AID - 10.1111/jce.15618 [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2022 Oct;33(10):2139-2151. doi: 10.1111/jce.15618. 
      Epub 2022 Jul 28.