Positive clinical benefit on patient care, quality of life and symptoms after radiofrequency ablation with contact force in persistent atrial fibrillation: analyses from PRECEPT

Author: Delaughter, C ; Athill, C.A ; Dukkipati, S ; Natale, A ; Gentlesk, P.J ; Patel, A ; Deville, B ; Marchlinski, F.E ; Calkins, H ; Osorio, J ; Mansour, M ; Pollack, S.J ; Macle, L ; Ellenbogen, K.A ; Melby, D

AbstractBackgroundThe management of persistent (PsAF) aims to prevent AF recurrence and associated disabilities while reducing side effects from treatment. Contact force (CF)-guided RF catheters have proven efficacious and safe for pulmonary vein isolation (PVI) to treat paroxysmal AF; however, there is limited evidence on clinical benefits with ablation of PsAF.PurposeTo assess long-term clinical effects on patients care, symptoms and QOL after CF-guided RF ablation in PsAF.MethodsPRECEPT was a multicenter study evaluating the safety and efficacy of CF RF catheters in the treatment of symptomatic PsAF (NCT02817776). PVI was performed with or without substrate modification. Patients were followed at 6, 9, 12 and 15 mos to collect the following data: Atrial Fibrillation Effect on Quality-of-Life (AFEQT) score, Canadian Cardiovascular Society Severity of Atrial Fibrillation (CCS-SAF) score, Class I/III AAD use, and incidence of cardioversion and cardiovascular hospitalization.ResultsA total of 333 enrolled patients (65.4±8.8 yrs, 71.2% male, CHA2DS2-VASC score 2.3±1.5) underwent PVI. Compared to baseline, 1) improvements in the AFEQT composite and subscores were seen from 6–15 mos, exceeding Clinical Important Difference (±5 points) in majority of subjects (Figure), 2) proportion of CCS-SAF Class 0 patients (asymptomatic with respect to AF) rose from 0.7% to 81.0%, 3) class I/III AAD use was reduced from 97.0% to 24.7%, and 4) incidence of cardioversion decreased from 62.0% to 10.7%. Moreover, the 1-yr Kaplan-Meier estimate of freedom from hospitalization was 84.2% [95% CI: 80.2%, 88.2%].ConclusionCF-guided RF ablation in PsAF patients led to a clinically meaningful improvement in QOL, as well as a reduction in AAD use, cardioversion, and hospitalization.Figure 1. Mean AFEQT composite and subscoreFunding AcknowledgementType of funding source: Private company. Main funding source(s): This study was funded by Biosense Webster, Inc.

01 Apr 2019·Journal of the American College of Cardiology

TCTAP C-192 Impact of Drug-coated Balloon Angioplasty for SFA Lesions with High-resolution Angioscopy

Author: Atsunori Okamura ; Kenshi Fujii ; Kota Tanaka ; Hiroyuki Nagai ; Akinori Sumiyoshi ; Mutsumi Iwamoto

### Patient Initials or Identifier Number JT ### Relevant Clinical History and Physical Exam An 81-year-old man with hypertension, dyslipidemia, and asthma was admitted to our hospital. He has intermittent claudication of bilateral lower limbs within 300 meters, a Rutherford classification of

01 Apr 2018·Journal of the American College of Cardiology

TCTAP C-071 The Neointimal Formation of Everolimus-eluting Stent Implanted in the Subintimal Space at Chronic Phase with Optical Coherence Tomography

Author: Atsunori Okamura ; Kota Tanaka ; Kenshi Fujii ; Takamasa Tanaka ; Hiroyuki Nagai ; Akinori Sumiyoshi ; Mutsumi Iwamoto ; Tomohiro Yamasaki

### Patient Initials or Identifier Number K.K ### Relevant Clinical History and Physical Exam A 67-year-old man was admitted to our hospital with silent myocardial infarction in January 2017. His coronary risk factor was hypertension. Coronary angiography (CAG) revealed a CTO at the proximal

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