Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: Outcomes of long-standing persistent atrial fibrillation ablation: A systematic review
Author: Brooks, A.
Stiles, M.
Laborderie, J.
Lau, D.
Kuklik, P.
Shipp, N.
Hsu, L.
Sanders, P.
Citation: Heart Rhythm, 2010; 7(6):835-846
Publisher: Elsevier Inc.
Issue Date: 2010
ISSN: 1547-5271
Statement of
Anthony G. Brooks, Martin K. Stiles, Julien Laborderie, Dennis H. Lau, Pawel Kuklik, Nicholas J. Shipp, Li-Fern Hsu, and Prashanthan Sanders
Abstract: <h4>Background</h4>Ablation of long-standing persistent atrial fibrillation (AF) is highly variable, with differing techniques and outcomes.<h4>Objective</h4>The purpose of this study was to undertake a systematic review of the literature with regard to the impact of ablation technique on the outcomes of long-standing persistent AF ablation.<h4>Methods</h4>A systematic search of the contemporary English scientific literature (from January 1, 1990 to June 1, 2009) in the PubMed database identified 32 studies on persistent/long-standing persistent or long-standing persistent AF ablation (including four randomized controlled trials). Data on single-procedure, drug-free success, multiple procedure success, and pharmaceutically assisted success at longest follow-up were collated.<h4>Results</h4>Four studies performed pulmonary vein isolation alone (21%-22% success). Four studies performed pulmonary vein antrum ablation with isolation (PVAI; n = 2; 38%-40% success) or without confirmed isolation (PVA; n = 2; 37%-56% success). Ten studies performed linear ablation in addition to PVA (n = 5; 11%-74% success) or PVAI (n = 5; 38%-57% success). Three studies performed posterior wall box isolation (n = 3; 44%-50% success). Five studies performed complex fractionated atrial electrogram ablation (n = 5; 24%-63% success). Six studies performed complex fractionated atrial electrogram ablation as an adjunct to PVA (n = 2; 50%-51% success), PVAI (n = 3; 36%-61% success), or PVAI and linear (n = 1; 68% success) ablation. Five studies performed the stepwise ablation approach (38%-62% success).<h4>Conclusion</h4>The variation in success within and between techniques suggests that the optimal ablation technique for long-standing persistent AF is unclear. Nevertheless, long-standing persistent AF can be effectively treated with a composite of extensive index catheter ablation, repeat procedures, and/or pharmaceuticals.
Keywords: Ablation
Atrial fibrillation
Systematic review
Long-standing persistent atrial fibrillation
Rights: © 2010 Heart Rhythm Society. All rights reserved.
DOI: 10.1016/j.hrthm.2010.01.017
Description (link):
Published version:
Appears in Collections:Aurora harvest 2
Molecular and Biomedical Science publications

Files in This Item:
File Description SizeFormat 
hdl_61531.pdfAccepted version2.05 MBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.