Detail
Článek
Článek online
FT
Medvik - BMČ
  • Je něco špatně v tomto záznamu ?

Targeting Nonpulmonary Vein Sources in Persistent Atrial Fibrillation Identified by Noncontact Charge Density Mapping: UNCOVER AF Trial

S. Willems, A. Verma, TR. Betts, S. Murray, P. Neuzil, H. Ince, D. Steven, A. Sultan, PM. Heck, MC. Hall, C. Tondo, L. Pison, T. Wong, LV. Boersma, C. Meyer, A. Grace,

. 2019 ; 12 (7) : e007233. [pub] 20190627

Jazyk angličtina Země Spojené státy americké

Typ dokumentu klinické zkoušky, časopisecké články, multicentrická studie, práce podpořená grantem, audiovizuální média

Perzistentní odkaz   https://www.medvik.cz/link/bmc20006214

Background Identification and elimination of nonpulmonary vein targets may improve clinical outcomes in patients with persistent atrial fibrillation (AF). We report on the use of a novel, noncontact imaging and mapping system that uses ultrasound to reconstruct atrial chamber anatomy and measures timing and density of dipolar, ionic activation (ie, charge density) across the myocardium to guide ablation of atrial arrhythmias. Methods The prospective, nonrandomized UNCOVER AF trial (Utilizing Novel Dipole Density Capabilities to Objectively Visualize the Etiology of Rhythms in Atrial Fibrillation) was conducted at 13 centers across Europe and Canada. Patients with persistent AF (>7 days, <1 year) aged 18 to 80 years, scheduled for de novo catheter ablation, were eligible. Before pulmonary vein isolation, AF was mapped and then iteratively remapped to guide each subsequent ablation of charge density-identified targets. AF recurrence was evaluated at 3, 6, 9, and 12 months using continuous 24-hour ECG monitors. The primary effectiveness outcome was freedom from AF >30 seconds at 12 months for a single procedure with a secondary outcome being acute procedural efficacy. The primary safety outcome was freedom from device/procedure-related major adverse events. Results Between October 2016 and April 2017, 129 patients were enrolled, and 127 underwent mapping and catheter ablation. Acute procedural efficacy was demonstrated in 125 patients (98%). At 12 months, single procedure freedom from AF on or off antiarrhythmic drugs was 72.5% (95% CI, 63.9%-80.3%). After 1 or 2 procedures, freedom from AF was 93.2% (95% CI, 87.1%-97.0%). A total of 29 (23%) retreatments because of arrhythmia recurrence were performed with average time from index procedure to first retreatment being 7 months. The primary safety outcome was 98% with no device-related major adverse events reported. Conclusions This novel ultrasound imaging and charge density mapping system safely guided ablation of nonpulmonary vein targets in persistent AF patients with 73% single procedure and 93% second procedure freedom from AF at 12 months. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT02825992 EU/NCT02462980 CN.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc20006214
003      
CZ-PrNML
005      
20200528090130.0
007      
ta
008      
200511s2019 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1161/CIRCEP.119.007233 $2 doi
035    __
$a (PubMed)31242746
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Willems, Stephan $u University Hospital, Hamburg, Germany (S.W., C.M.).
245    10
$a Targeting Nonpulmonary Vein Sources in Persistent Atrial Fibrillation Identified by Noncontact Charge Density Mapping: UNCOVER AF Trial / $c S. Willems, A. Verma, TR. Betts, S. Murray, P. Neuzil, H. Ince, D. Steven, A. Sultan, PM. Heck, MC. Hall, C. Tondo, L. Pison, T. Wong, LV. Boersma, C. Meyer, A. Grace,
520    9_
$a Background Identification and elimination of nonpulmonary vein targets may improve clinical outcomes in patients with persistent atrial fibrillation (AF). We report on the use of a novel, noncontact imaging and mapping system that uses ultrasound to reconstruct atrial chamber anatomy and measures timing and density of dipolar, ionic activation (ie, charge density) across the myocardium to guide ablation of atrial arrhythmias. Methods The prospective, nonrandomized UNCOVER AF trial (Utilizing Novel Dipole Density Capabilities to Objectively Visualize the Etiology of Rhythms in Atrial Fibrillation) was conducted at 13 centers across Europe and Canada. Patients with persistent AF (>7 days, <1 year) aged 18 to 80 years, scheduled for de novo catheter ablation, were eligible. Before pulmonary vein isolation, AF was mapped and then iteratively remapped to guide each subsequent ablation of charge density-identified targets. AF recurrence was evaluated at 3, 6, 9, and 12 months using continuous 24-hour ECG monitors. The primary effectiveness outcome was freedom from AF >30 seconds at 12 months for a single procedure with a secondary outcome being acute procedural efficacy. The primary safety outcome was freedom from device/procedure-related major adverse events. Results Between October 2016 and April 2017, 129 patients were enrolled, and 127 underwent mapping and catheter ablation. Acute procedural efficacy was demonstrated in 125 patients (98%). At 12 months, single procedure freedom from AF on or off antiarrhythmic drugs was 72.5% (95% CI, 63.9%-80.3%). After 1 or 2 procedures, freedom from AF was 93.2% (95% CI, 87.1%-97.0%). A total of 29 (23%) retreatments because of arrhythmia recurrence were performed with average time from index procedure to first retreatment being 7 months. The primary safety outcome was 98% with no device-related major adverse events reported. Conclusions This novel ultrasound imaging and charge density mapping system safely guided ablation of nonpulmonary vein targets in persistent AF patients with 73% single procedure and 93% second procedure freedom from AF at 12 months. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT02825992 EU/NCT02462980 CN.
650    12
$a akční potenciály $7 D000200
650    _2
$a mladiství $7 D000293
650    _2
$a dospělí $7 D000328
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a fibrilace síní $x diagnostické zobrazování $x patofyziologie $x chirurgie $7 D001281
650    _2
$a katetrizační ablace $7 D017115
650    _2
$a elektrokardiografie ambulantní $7 D015716
650    12
$a elektrofyziologické techniky kardiologické $7 D022062
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a převodní systém srdeční $x diagnostické zobrazování $x patofyziologie $x chirurgie $7 D006329
650    12
$a srdeční frekvence $7 D006339
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a nerandomizované kontrolované studie jako téma $7 D065228
650    _2
$a prediktivní hodnota testů $7 D011237
650    _2
$a doba přežití bez progrese choroby $7 D000077982
650    _2
$a prospektivní studie $7 D011446
650    _2
$a venae pulmonales $x patofyziologie $7 D011667
650    _2
$a recidiva $7 D012008
650    _2
$a časové faktory $7 D013997
650    12
$a ultrasonografie $7 D014463
650    _2
$a mladý dospělý $7 D055815
651    _2
$a Kanada $7 D002170
651    _2
$a Evropa $7 D005060
655    _2
$a klinické zkoušky $7 D016430
655    _2
$a časopisecké články $7 D016428
655    _2
$a multicentrická studie $7 D016448
655    _2
$a práce podpořená grantem $7 D013485
655    _2
$a audiovizuální média $7 D059040
700    1_
$a Verma, Atul $u Southlake Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada (A.V., P.M.H.).
700    1_
$a Betts, Timothy R $u Oxford Biomedical Research Centre (T.R.B.).
700    1_
$a Murray, Steven $u Freeman Hospital, Newcastle Upon Tyne, United Kingdom (S.M.).
700    1_
$a Neuzil, Petr $u Na Homolce Hospital, Prague, Czech Republic (P.N.).
700    1_
$a Ince, Hüseyin $u University Hospital Rostock, Berlin (H.I.). Vivantes Klinikum, Berlin (H.I.).
700    1_
$a Steven, Daniel $u University Hospital Cologne, Germany (D.S., A.S.).
700    1_
$a Sultan, Arian $u University Hospital Cologne, Germany (D.S., A.S.).
700    1_
$a Heck, Patrick M $u Southlake Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada (A.V., P.M.H.).
700    1_
$a Hall, Mark C $u Liverpool Heart and Chest Hospital, United Kingdom (M.C.H.).
700    1_
$a Tondo, Claudio $u Centro Cardiologico Monzino, Milan, Italy (C.T.).
700    1_
$a Pison, Laurent $u Maastricht University Medical Center, the Netherlands (L.P.). Zienkenhuis Oost Limburg, Belgium (L.P.).
700    1_
$a Wong, Tom $u Royal Brompton Hospital and Harefield NHS Foundation Trust, London, United Kingdom (T.W.).
700    1_
$a Boersma, Lucas V $u St. Antonius Hospital, Nieuwegein, the Netherlands (L.V.B.). Amsterdam University Medical Center, the Netherlands (L.V.B.).
700    1_
$a Meyer, Christian $u University Hospital, Hamburg, Germany (S.W., C.M.).
700    1_
$a Grace, Andrew $u Royal Papworth Hospital Foundation Trust, Cambridge (A.G.).
773    0_
$w MED00159578 $t Circulation. Arrhythmia and electrophysiology $x 1941-3084 $g Roč. 12, č. 7 (2019), s. e007233
856    41
$u https://pubmed.ncbi.nlm.nih.gov/31242746 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y a $z 0
990    __
$a 20200511 $b ABA008
991    __
$a 20200528090127 $b ABA008
999    __
$a ok $b bmc $g 1525072 $s 1096270
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2019 $b 12 $c 7 $d e007233 $e 20190627 $i 1941-3084 $m Circulation. Arrhythmia and electrophysiology $n Circ Arrhythm Electrophysiol $x MED00159578
LZP    __
$a Pubmed-20200511

Najít záznam

Citační ukazatele

Možnosti archivace