Author + information
- John D. Hummel,
- Atul Verma,
- Daryl Gress,
- Lee Schwamm and
- Lucas Boersma
Background: Catheter ablation for persistent and long standing persistent atrial fibrillation (PersAF) is challenging and associated with less favorable outcomes and higher risk of thromboembolic events. VICTORY AF is a prospective, multi-center, controlled study that rigorously and independently evaluated the incidence of stroke in PersAF patients treated with the Phased RF (PRF) catheter ablation system.
Methods: PersAF patients without major structural heart disease and without history of stroke/TIA were treated with the PRF system (PVAC GOLD, MASC, MAAC). A rigorous stroke evaluation was done by neurologist at baseline, discharge, 30 days, and any unscheduled visits. The primary safety endpoint was clinical stroke rate within 30 days of ablation. Diagnosis of stroke according to predefined criteria included brain imaging and was adjudicated by an independent committee of neurologists, a neuro-radiologist, and electrophysiologists.
Results: A total of 129 (108 persistent, 21 long-standing persistent AF) patients underwent 149 procedures (mean age 60.6 ± 7.7; 79.8% male, 54.3% CHA2DS2-VASc score ≥2). INR and ACT levels were 2.53 ± 0.43 and 398 ± 97 sec, respectively, with 1.5 ±1.2 electrical cardioversions performed during the procedure. Sinus rhythm post-procedure was achieved in 98.6% of procedures. Two strokes were observed. Both strokes were minor and non-disabling (INR = 2.17 and 2.14 respectively at pre-procedure, NIHSS 1, mRS 0-1 at diagnosis). One stroke occurred prior to discharge and another was diagnosed at the 30 day visit having occurred after electrical cardioversion on day 22 post-ablation.
Conclusions: VICTORY AF is a study with extensive neurologist involvement to evaluate stroke in PersAF patients undergoing catheter ablation. The two adjudicated strokes were minor and non-disabling. The preliminary results demonstrate a high rate of initial procedure success and safety profile in line with prior studies in this patient population.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Atrial Fibrillation and VT: Unique Populations and Solutions
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1151-110
- 2017 American College of Cardiology Foundation