Pulmonary Vein Re-Isolation as a Routine Strategy Regardless of Symptoms: The PRESSURE Randomized Controlled Trial

JACC. Clinical Electrophysiology
Moloy DasDhiraj Gupta

Abstract

The goal of this study was to determine whether a strategy of early re-isolation of pulmonary vein (PV) reconnection in all patients, regardless of symptoms, would reduce the recurrence of atrial fibrillation (AF) and improve quality of life. Lasting pulmonary vein isolation (PVI) remains elusive. PV reconnection is strongly linked to the recurrence of arrhythmia. A total of 80 patients with paroxysmal AF were randomized 1:1 after contact force-guided PVI to receive either standard care or undergo a repeat electrophysiology study after 2 months regardless of symptoms (repeat study). At the initial procedure, PVI was demonstrated by entrance/exit block and adenosine administration after a minimum 20-min wait. At the repeat study, all sites of PV reconnection were re-ablated. Patients recorded electrocardiograms daily and whenever symptomatic for 12 months using a handheld monitor. Recurrence was defined as ≥30 s of atrial tachyarrhythmia (AT) after a 3-month blanking period. The Atrial Fibrillation Effect on Quality-of-Life Questionnaire was completed at baseline and at 6 and 12 months. All 40 patients randomized to repeat study attended for this after 62 ± 6 days, of whom 25 (62.5%) had reconnection of 41 (26%) PVs. There were ...Continue Reading

References

Apr 1, 1988·Pacing and Clinical Electrophysiology : PACE·S K HuangK Wharton
Oct 1, 1989·Circulation·F H WittkampfE O Robles de Medina
Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
Sep 15, 2004·Journal of Cardiovascular Electrophysiology·David J CallansFrancis E Marchlinski
Sep 28, 2007·European Heart Journal·Paulus KirchhofGünter Breithardt
Mar 8, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Sakis ThemistoclakisAndrea Natale
May 9, 2008·Journal of Cardiovascular Electrophysiology·Nicolas LelloucheMichel Haïssaguerre
Nov 26, 2008·Circulation·Pierre JaïsMichel Haïssaguerre
Oct 3, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gerrit KaleschkePaulus Kirchhof
Dec 10, 2009·Circulation. Arrhythmia and Electrophysiology·Riccardo CappatoElia Biganzoli
Jan 28, 2010·JAMA : the Journal of the American Medical Association·David J WilberUNKNOWN ThermoCool AF Trial Investigators
May 22, 2010·Journal of the American College of Cardiology·Anita WokhluDouglas L Packer
Jan 17, 2015·Circulation. Arrhythmia and Electrophysiology·James L HarrisonMark D O'Neill
May 7, 2015·The New England Journal of Medicine·Atul VermaUNKNOWN STAR AF II Investigators
Jun 5, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Josef KautznerKarl-Heinz Kuck
Jul 19, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jackson J LiangSanjay Dixit
Aug 26, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Yonghui ZhaoAndrea Natale
Oct 13, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hamid GhanbariAman Chugh
Apr 5, 2016·The New England Journal of Medicine·Karl-Heinz KuckUNKNOWN FIRE AND ICE Investigators

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Citations

May 4, 2018·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Henry ChubbReza Razavi
Nov 30, 2019·Journal of Cardiovascular Electrophysiology·Peter M Kistler, David Chieng
Jul 28, 2020·Circulation Research·F Daniel RamirezPierre Jaïs
Feb 26, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Clemens Jilek, Waqas Ullah
Sep 21, 2019·Pacing and Clinical Electrophysiology : PACE·Stefano BartolettiDhiraj Gupta
Jul 15, 2021·Journal of Cardiovascular Electrophysiology·John-Ross D ClarkeDaniel J Friedman
Nov 16, 2021·European Journal of Nuclear Medicine and Molecular Imaging·Jana KupusovicJohannes Siebermair
Dec 25, 2021·Journal of Cardiovascular Electrophysiology·Dimitrios A VrachatisSpyridon Deftereos

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