Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation: efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation
| Autor: | Claudio Di Gioia, Cosimo Dicandia, Filippo Gugliotta, Vincenzo Santinelli, Eleonora Ficarra, Monica Tocchi, Patrizio Mazzone, Simone Gulletta, Stefano Nardi, Ottavio Alfieri, Carlo Pappone, Maria Pia Calabrò, Salvatore Rosanio, Giuseppe Oreto, Stefano Benussi, Adriano Salvati, Gabriele Vicedomini |
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| Přispěvatelé: | Pappone, C, Oreto, G, Rosanio, S, Vicedomini, G, Tocchi, M, Gugliotta, F, Salvati, A, Dicandia, C, Calabro, Mp, Mazzone, P, Ficarra, E, Di Gioia, C, Gulletta, S, Nardi, S, Santinelli, V, Benussi, S, Alfieri, Ottavio |
| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
Radiofrequency ablation medicine.medical_treatment Catheter ablation law.invention Pulmonary vein Cohort Studies law Heart Rate Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Sinus rhythm Heart Atria Fibrillation business.industry Atrial fibrillation Middle Aged medicine.disease Ablation Ostium Treatment Outcome Pulmonary Veins Cardiology Catheter Ablation Feasibility Studies medicine.symptom Cardiology and Cardiovascular Medicine business Electrophysiologic Techniques Cardiac |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1524-4539 |
| Popis: | Background Circumferential radiofrequency ablation around pulmonary vein (PV) ostia has recently been described as a new anatomic approach for atrial fibrillation (AF). Methods and Results We treated 251 consecutive patients with paroxysmal (n=179) or permanent (n=72) AF. Circular PV lesions were deployed transseptally during sinus rhythm (n=124) or AF (n=127) using 3D electroanatomic guidance. Procedures lasted 148±26 minutes. Among 980 lesions surrounding individual PVs (n=956) or 2 ipsilateral veins with close openings or common ostium (n=24), 75% were defined as complete by a bipolar electrogram amplitude 30 ms across the line. The amount of low-voltage encircled area was 3594±449 mm 2 , which accounted for 23±9% of the total left atrial (LA) map surface. Major complications (cardiac tamponade) occurred in 2 patients (0.8%). No PV stenoses were detected by transesophageal echocardiography. After 10.4±4.5 months, 152 patients with paroxysmal AF (85%) and 49 with permanent AF (68%) were AF-free. Patients with and without AF recurrence did not differ in age, AF duration, prevalence of heart disease, or ejection fraction, but the LA diameter was significantly higher ( P P Conclusions Circumferential PV ablation is a safe and effective treatment for AF. Its success is likely due to both PV trigger isolation and electroanatomic remodeling of the area encompassing the PV ostia. |
| Databáze: | OpenAIRE |
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