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https://hdl.handle.net/2440/42234
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Type: | Journal article |
Title: | Complete isolation of the pulmonary veins and posterior left atrium in chronic atrial fibrillation. Long-term clinical outcome |
Author: | Sanders, P. Hocini, M. Jais, P. Sacher, F. Hsu, L. Takahashi, Y. Rotter, M. Rostock, T. Nalliah, C. Clementy, J. Haissaguerre, M. |
Citation: | European Heart Journal, 2007; 28(15):1862-1871 |
Publisher: | W B Saunders Co Ltd |
Issue Date: | 2007 |
ISSN: | 0195-668X 1522-9645 |
Statement of Responsibility: | Prashanthan Sanders, Mélèze Hocini, Pierre Jaïs, Fréderic Sacher, Li-Fern Hsu, Yoshihide Takahashi, Martin Rotter, Thomas Rostock, Chrishan J. Nalliah, Jacques Clémenty and Michel Haïssaguerre |
Abstract: | <h4>Aims</h4>To evaluate the contribution of the posterior left atrium (LA) to chronic atrial fibrillation (AF).<h4>Methods and results</h4>Twenty-seven patients with chronic-AF were studied. After pulmonary vein (PV) isolation, the posterior-LA was isolated by ablation joining the right- and left-PVs using an irrigated-tip catheter. Isolation was demonstrated by absent/dissociated posterior-LA activity and the inability to pace the region. Ablation impact was determined by the effect on cycle length (CL) and AF termination. Posterior-LA isolation was achieved using 35 +/- 12 min of radiofrequency with total fluoroscopic and procedural durations of 64 +/- 16 and 199 +/- 46 min, resulting in abolition of electrograms (n = 21) or autonomous activity (n = 6; CL 820 +/- 343 ms). AFCL increased from 156 +/- 28 ms to 162 +/- 27 ms with PV-isolation and to 175 +/- 32 ms by posterior-LA exclusion (P < 0.0001). AF persisted in all after PV-isolation and terminated in 5 (19%) during posterior-LA-isolation. After 10 +/- 6 months, 12 patients developed atrial tachycardia (four) or AF (eight); four underwent repeat posterior-LA-isolation, while the others required additional ablation/antiarrhythmics. After 21 +/- 5 months, 17 (63%) were in sinus rhythm following posterior-LA-isolation.<h4>Conclusion</h4>This study demonstrates the feasibility of complete posterior-LA exclusion by catheter ablation. This strategy results in maintenance of sinus rhythm in 63% at 2 years follow-up. |
Keywords: | Atrial fibrillation Arrhythmia Ablation Electrophysiology |
Description: | © The European Society of Cardiology 2007. All rights reserved. |
Provenance: | Previous Presentation: Presented in part at the Heart Rhythm Society's 26th Annual Scientific Sessions, New Orleans, May 2005 and published in abstract form (Heart Rhythm 2005;2:S228–S229). |
DOI: | 10.1093/eurheartj/ehl548 |
Published version: | http://dx.doi.org/10.1093/eurheartj/ehl548 |
Appears in Collections: | Aurora harvest Medicine publications |
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