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Abstract Book Oral Abstracts ABSTRACT SESSION 1 PROUDLY HOSTED BY Asia Pacific heart Rhythm Society scientific Sessions 19–22 NOVEMBER 2015 | MELBOURNE, AUSTRALIA In conjunction with the 11th Asia Pacific Atrial Fibrillation Symposium ABSTRACTS Endorsed by Supported by ISSN: 1883-2148 Contents Oral abstracts 03 GO YIA abstracts 08 GO Late breaking abstracts 11 GO Snapshot abstracts 14 GO Poster abstracts Friday 20 November 2015 Session 1 41 GO Friday 20 November 2015 Session 2 104 GO Saturday 21 November 2015 Session 1 168 GO Saturday 21 November 2015 Session 2 235 GO Sunday 22 November 2015 Session 1 301 GO 2 8th Asia Pacific Heart Rhythm Society Scientific Sessions| Abstract Book Oral abstracts ABSTRACT SESSION 1 FRIDAY 20 NOVEMBER 2015 Room 213 1:50:00 PM - 3:30:00 PM THE VOLUME OF LEFT ATRIUM MEASURED BY MULTI- THE IMPACT OF NONPAROXYSMAL ATRIAL FIBRILLATION DETECTOR COMPUTED TOMOGRAPHY CAN PREDICT ON STROKE, BLEEDING AND DEATH: A SYSTEMATIC OF LONG TERM OUTCOME IN CATHETER ABLATION OF REVIEW AND META-ANALYSIS ATRIAL FIBRILLATION Authors Authors Anand Ganesan, Derek Chew, Trent Hartshorne, Joseph Selvanayagam, Yoo Ri Kim, Jong Pil Yun, Jung Hae Kwon, Jun Kim, Gi-Byoung Nam, Kee- Prashanthan Sanders and Andrew McGavigan. Flinders Medical Centre, Joon Choi and You-Ho Kim. Incheon St. Mary’s Hospital, Incheon, Korea, Bedford Park, Australia, University of Adelaide, Adelaide, Australia Republic of, Asan Medical Center, Seoul, Korea, Republic of Disclosures Disclosures A. Ganesan: None. D. Chew: None. T. Hartshorne: None. J. Y. Kim: None. J. Yun: None. J. Kwon: None. J. Kim: None. G. Nam: Selvanayagam: None. P. Sanders: None. A. McGavigan: None. None. K. Choi: None. Y. Kim: None. Abstract Abstract Introduction: Thromboembolic risk stratification schemes for atrial Introduction: This study will identify the left atrium (LA) and left atrial fibrillation regard risk as independent of classification into paroxysmal appendage (LAA) volumes calculated by multidetector computed (PAF) and nonparoxysmal atrial fibrillation (NPAF). The current study was tomography (MDCT) is related to the long term out come of radiofrequency a systematic review and meta-analysis evaluating the impact of AF type on catheter ablation (RFCA) for atrial fibrillation(AF). thromboembolism, bleeding and mortality. Methods: We analyzed data from 99 consecutive patients who referred for Methods: Pubmed was searched through November 27 2014 for RFCA of drug-refractory symptomatic AF (age 56±10 years; 74% men; 64% randomized controlled trials, cohort studies, and case series reporting paroxysmal AF[PAF]). Prior to the procedure, all patients underwent ECG- prospectively collected clinical outcomes stratified by AF type. The gated 128 channels MDCT scan for assessment for PV anatomy, LA and incidence of thromboembolism, mortality and bleeding was extracted. LAA volume estimation, and electro-anatomical mapping intergration. Results: AF clinical outcome data was extracted from 12 studies Results: The volume of LA and LAA were 142.6±32.2 mL and 14.7±6.0 containing 99,996 patients. The pooled unadjusted risk ratio (RR) for mL, respectively. LA volume was smaller in PAF than persistent AF(PeAF) thromboembolism in NPAF vs. PAF was RR 1.369 (95% CI: 1.140-1.644, (133.9±29.3mL vs. 158.0±31.4mL, p<0.0001) but LAA volume was not P<0.001). In studies providing estimates of thromboembolism risk significantly different between PAF and PeAF(13.9±5.0mL vs. 16.3±7.3mL, adjusted for baseline clinical risk factors, the pooled adjusted hazard p=0.09). Patients were classified into 2 groups by the LA volume of 160mL; ratio (HR) in NPAF vs. PAF was HR 1.384 (95% CI, 1.191-1.608, P<0.001). group 1 (LA volume < 160mL,n=73) and group 2 (LA volume ≥160mL, The pooled unadjusted risk ratio for all-cause mortality in NPAF vs. PAF n=26). After a mean follow up 12.6 ± 5.3 months, 78.8% of the patients was RR 1.462 (95% CI: 1.255-1.703 P<0.001). The pooled adjusted HR for maintained sinus rhythm after the index ablation. AF free survival was all-cause mortality in NPAF vs. PAF was HR 1.217 (95% CI: 1.085-1.365, significantly greater in group 1 than group 2 (84.9% vs. 61.5% p=0.017). P<0.001. Rates of bleeding in NPAF and PAF were similar, unadjusted RR No relationship was found between LAA volume and the outcome of 1.00 (95% CI 0.919-1.087, P=0.994), pooled adjusted HR 1.025 (95% CI: RFCA. Multivariate analysis showed that the LA volume >160mL was an 0.898-1.170, P=0.715). independent predictor of arrhythmia-free after ablation (Hazard ration 2.55, 95% confidential interval 1.02-6.35, p=0.045) Conclusions: These data suggest a need for re-evaluation of the paradigm of thromboembolic risk equivalence between PAF and NPAF, Conclusions: Higher LA volume is independent risk factor for AF and emphasize AF type as a powerful predictor of AF-related morbidity recurrence after RFCA but not LAA volume. The LA volume quickly and mortality. Future studies exploring integration of AF type into assessed by MDCT could be a good predictor of long term recurrence thromboembolic risk models are needed. after AF abltion. 8th Asia Pacific Heart Rhythm Society Scientific Sessions| Abstract Book 3 Oral abstracts ABSTRACT SESSION 1 FRIDAY 20 NOVEMBER 2015 Room 103 1:20:00 PM - 3:00:00 PM WHICH PATIENTS RECUR AS ATRIAL TACHYCARDIA AFTER IMPACT OF WEIGHT REDUCTION ON THE PROGRESSION CATHETER ABLATION FOR ATRIAL FIBRILLATION? OF AF: THE PROGRESS AF STUDY Authors Authors Young-Ah Park, Tae-Hoon Kim, Jae-Sun Uhm, Jong-yun Kim, Boyoung Melissa Middeldorp, Rajeev Pathak, Megan Meredith, Abhinav Mehta, Joung, Moon-Hyoung Lee and Hui-Nam Pak. Yonsei University, Severance Rajiv Mahajan, Adrian Elliott, Dennis Lau and Prashanthan Sanders. Hospital, Seoul, Korea, Republic of University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia, Australian National University, Canberra, Australia Disclosures Disclosures Y. Park: None. T. Kim: None. J. Uhm: None. J. Kim: None. B. Joung: None. M. Lee: None. H. Pak: None. M. Middeldorp: None. R. Pathak: None. M. Meredith: None. A. Mehta: None. R. Mahajan: None. A. Elliott: None. D. Lau: None. P. Sanders: Abstract A - Consulting Fees/Honoraria; 1; Medtronic, Biosense-Webster, St Jude Medical. I - Research Grants; 4; Sorin, Biotronik. I - Research Grants; 5; Introduction: Although it has been vaguely considered that linear Medtronic, St Jude Medical, Boston Scientific. ablation gap or low atrial critical mass are related to atrial tachycardia (AT) recurrence after radiofrequency catheter ablation (RFCA) for atrial Abstract fibrillation (AF), it is not clear which patients recur as AT or AF. The aim of this study is to discriminate the clinical factors associated with AT Introduction: Atrial Fibrillation (AF) is a progressive disease. The LEGACY recurrence compared with recurrence as AF after RFCA. study demonstrated a dose-response effect on AF of weight reduction. In the current study, we aim to look at the impact of weight loss on the progression of the AF disease. Methods: Among 1425 patients who underwent AF ablation, we included 283 patients (72% male, 58±11 years old, 62% paroxysmal AF) who showed Methods: Of 1415 consecutive patients with AF, 825 had BMI≥27 kg/ electrocardiogram (ECG)-documented clinical recurrence 3 months after m2 and were offered weight management. After screening for exclusion RFCA. We excluded all the patients who were taking antiarrhythmic drug criteria, 355 were included in this analysis. Weight-loss was categorized at time of clinical recurrence. Patients were classified as circumferential as: Group-1 (>10%); Group-2 (3-9%); and Group-3 (<3%). Change in AF pulmonary vein isolation (CPVI) only group (n=127) and PVI with type was determined by clinic review and 7-day Holter monitoring at 12 additional linear ablation (CPVI+Line) group (n=156), and clinical, imaging monthly intervals. AF type was categorized as per HRS consensus. parameters, and the number of linear lesions were determined. Results: There were no differences in baseline characteristic or follow up duration between the groups (p=NS). At final follow up: 116 patients Results: 1. The timing of clinical recurrence was 13±9 months after RFCA, (86%) in Group 1 were free from AF (40% without ablation, 37%: 1 ablation and 37.5% (36/96) recurred as AT. The proportion of AT recurrence was & 23%: multiple ablation); 69 patients (67%) in Group 2 were free from AF 29.1% (37/127) in CPVI only group and 33.3% (52/156) in CPVI+Line group (37% without ablation, 36%: 1 ablation & 27%: multiple ablation); and 45 (p=0.520). patients (39%) in Group 3 were free from AF (11% without ablation, 36%: 2. Patients with AT recurrence were more likely to have smaller left atrial 1 ablation & 53%: multiple ablation). The table shows the change in AF (LA) volume index measured by CT (LAVI; 70.4±22.1 vs 82.2±27.3cm3, disease state in each of the groups. There was no difference in number of p=0.002) and left ventricular mass index (LVMI; 88.0±19.1 vs 95.1±23.4g/ patients requiring AV node ablation or pacemaker implantation between m2, p=0.026), and higher LA voltage (1.23±0.61 vs 0.98±0.57mV, p=0.008) the 3 groups (p=NS). than patients with AF recurrence. In logistic regression analysis, Anterior LAVI (OR 0.97, 95% CI 0.94~1.00, p=0.048) and LA voltage during procedure Conclusion: Weight loss is associated with significant reduction of AF (OR 2.85, 95% CI 1.25~6.51, p=0.013) were independently associated with burden and improved maintenance of sinus rhythm.
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