Effect of periprocedural @entity2643 on procedure outcome in longstanding persistent XXXX undergoing extended pulmonary vein antrum isolation: Results from a randomized study (SPECULATE).

@entity1 @entity2643 @entity3044 @entity955
BACKGROUND: The impact of @entity2643 on ablation outcome in longstanding persistent @entity955 (LSPAF) @entity1 is not known yet. OBJECTIVE: The purpose of this study was to assess the effect of @entity2643 on procedural-outcomes in LSPAF @entity1 undergoing catheter ablation. METHODS: We enrolled 112 LSPAF @entity1 on @entity2643 and scheduled to undergo @entity955 ( @entity955 ) ablation. @entity1 were randomized to @entity2643 discontinuation 4 months before ablation (group 1, n = 56) and a control group (group 2, n = 56) in which ablation was performed without @entity2643 discontinuation. All @entity1 underwent pulmonary vein (PV) antrum and posterior wall isolation, defragmentation and extra PV triggers ablation. @entity1 were followed up for recurrence for 32    8 months post-ablation. Repeat procedures in all recurrent @entity1 were performed off @entity2643 . RESULTS: During ablation, @entity955 termination was more frequent in group 2 compared to group 1 [44 (79%) vs 32 (57%), P = .015]. After high-dosage @entity3044 , more non-PV triggers were disclosed in group 1 compared to group 2 (42 [75%] vs 24 [43%] respectively, P <.001). Group 2 had lower procedure, radiofrequency and fluoroscopy times compared to group 1 (2.7    1 vs 3.1    1 h, 69    13 min vs 87    11 min and 64    14 min vs 85    18 min respectively). At 32    8 month follow-up, on or off antiarrhythmic drug success rate was 37 (66%) in group 1 and 27 (48%) in group 2 (P = .04). During redo, new non-PV trigger sites were identified in group 2 @entity1 . CONCLUSION: Periprocedural continuous @entity2643 was associated with higher organization rate and lower radiofrequency ablation rate. However, masking non-PV triggers increased the late recurrence rate.
