Affordable Access

Publisher Website

Pulmonary Vein Isolation as an End Point for Left Atrial Circumferential Ablation of Atrial Fibrillation

Authors
Journal
Journal of the American College of Cardiology
0735-1097
Publisher
Elsevier
Publication Date
Volume
46
Issue
6
Identifiers
DOI: 10.1016/j.jacc.2005.05.069
Disciplines
  • Medicine

Abstract

Objectives We sought to determine whether elimination of pulmonary vein (PV) arrhythmogenicity is necessary for the efficacy of left atrial circumferential ablation (LACA) for atrial fibrillation (AF). Background The PVs often provide triggers or drivers of AF. It has been shown that LACA is more effective than PV isolation in eliminating paroxysmal AF. However, it is not clear whether complete PV isolation is necessary for the efficacy of LACA. Methods In 60 consecutive patients with paroxysmal (n = 39) or chronic (n = 21) AF (mean age 53 ± 12 years), LACA to encircle the left- and right-sided PVs, with additional lines in the posterior left atrium and along the mitral isthmus, was performed under the guidance of an electroanatomic navigation system. The PVs were mapped with a decapolar ring catheter before and after LACA. If PV isolation was incomplete, no attempts at complete isolation were made. Results After LACA, there was incomplete electrical isolation of one or more PVs in 48 (80%) of the 60 patients. The prevalence of PV tachycardias was 82% before and 8% after LACA (p < 0.001). At 11 ± 1 months of follow-up, 10 (83%) of the 12 patients with complete and 39 (81%) of 48 patients with incomplete PV isolation were free from recurrent AF without antiarrhythmic drug therapy (p = 1.0). A successful outcome was not related to the number of completely isolated PVs per patient (p = 0.6). Conclusions Left atrial circumferential ablation modifies the arrhythmogenic substrate within the PVs. Complete electrical isolation of the PVs is not a requirement for a successful outcome after LACA.

There are no comments yet on this publication. Be the first to share your thoughts.

Statistics

Seen <100 times
0 Comments

More articles like this

Pulmonary vein isolation as an end point for left...

on Journal of the American Colleg... Sep 20, 2005

Circumferential ablation with pulmonary vein isola...

on The American Journal of Cardio... May 15, 2007

Circumferential Ablation With Pulmonary Vein Isola...

on The American Journal of Cardio... Jan 01, 2007

Circumferential pulmonary vein ablation with addit...

on Circulation. Arrhythmia and el... June 2010
More articles like this..