Efficacy of ablation at the anteroseptal line for the treatment of perimitral flutter
| Autor: | Bernard Abi-Saleh, Walid Saliba, Hadi Skouri, Patrick J. Tchou, Jeffery Fowler, Oussama M. Wazni, Daniel J. Cantillon |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_treatment Perimitral flutter LA Left atrium Right superior pulmonary vein LAA Left atrial appendage Ablation Left atrial Internal medicine medicine AF Atrial fibrillation CS Coronary sinus CTI Cavotricuspid isthmus Mitral annulus cardiovascular diseases PVI Pulmonary vein isolation Coronary sinus business.industry RF Radiofrequency PMF Perimitral flutter Atrial fibrillation medicine.disease Left atrial anteroseptal line lcsh:RC666-701 ICE Intracardiac echocardiography Cardiology cardiovascular system Flutter Original Article MA Mitral annulus Cardiology and Cardiovascular Medicine business AAD Antiarrhythmic drug RSVP Right superior pulmonary vein |
| Zdroj: | Journal of Arrhythmia Journal of Arrhythmia, Vol 31, Iss 6, Pp 359-363 (2015) |
| ISSN: | 1880-4276 |
| DOI: | 10.1016/j.joa.2015.06.001 |
| Popis: | Background: Left atrial flutter following atrial fibrillation (AF) ablation is increasingly common and difficult to treat. We evaluated the safety and efficacy of ablation of the anteroseptal line connecting the right superior pulmonary vein (RSPV) to the anteroseptal mitral annulus (MA) for the treatment of perimitral flutter (PMF). Methods: We systematically studied patients who were previously treated with AF ablation and who presented to the electrophysiology laboratory with atrial tachyarrhythmias between January 2000 and July 2010. The diagnosis of PMF was confirmed by activation mapping and/or entrainment. After re-isolation of any recovered pulmonary vein, a linear radiofrequency (RF) ablation was performed on the line that connected the RSPV to the anteroseptal MA. In this analysis, we included only patients who were treated with an anteroseptal line for their PMF. Results: Ablation was performed at the anteroseptal line in 27 PMF patients (63±13 years; 9 women) who had undergone prior ablation for paroxysmal (n=3) or persistent (n=24) AF, using electroanatomic activation mapping (70% CARTO, 30% NavX). The anteroseptal ablation line was effective in 22/27 (81.5%) patients in the acute-care setting. Termination of AF to sinus rhythm occurred in 15/22 (68.2%) patients, and 7/22 (31.8%) patients׳ AF converted to another right or left atrial flutter. At the 6-month follow-up, 20% of patients demonstrated recurrent left atrial tachyarrhythmia. Only one patient required repeat ablation, and the remaining patients׳ condition was controlled with antiarrhythmic medications. No major procedural complications or heart block occurred. Conclusion: Ablation at the left atrial anteroseptal line is safe and efficacious for the treatment of PMF. Unlike ablation at the traditional mitral isthmus line, ablation at the left atrial anteroseptal line does not require ablation in the coronary sinus. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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