| Catheter ablation of right atrial ganglionated plexi in patients with vagal paroxysmal atrial fibrillation. | |
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MedLine Citation:
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PMID: 22147839 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Catheter ablation of ganglionated plexi (GP) in the left atrium has been proposed in different subgroup of patients with atrial fibrillation (AF). Anatomic studies found a high prevalence of GP in the posterior surface of the right atrium (RA). Experimental data suggested the potential role of right atrial GP in the AF initiation and maintenance. The aim of our study was to assess the efficacy of GP ablation in RA in patients with vagal AF. METHODS AND RESULTS: Thirty-four patients without structural heart diseases were randomly assigned for a selective ablation procedure targeted on the elimination of vagal reflex evoked by high frequency stimulation or an extensive approach at anatomic sites of GP. All patients underwent Holter ECG and heart rate variability evaluation at baseline and at 3, 6, 12, and 18 months of follow-up. At a mean follow-up of 19.7±5.2 months, AF recurred in 5 of 17 patients with anatomic ablation and in 13 of 17 patients with a selective approach (P=0.01). No patient had major complications. After ablation, heart rate variability parameters showed a significant parasympathetic (and sympathetic) denervation in the first 6 months, which was more prominent in patients with anatomic GP ablation and in those without AF recurrence. CONCLUSIONS: This study demonstrates that in a selected population of vagal paroxysmal AF, the anatomic ablation of GPs in the RA is effective in about 70% of patients. These results confirm that atrial vagal denervation can abolish AF, as suggested by experimental and clinical data. |
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Authors:
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Leonardo Calò; Marco Rebecchi; Luigi Sciarra; Lucia De Luca; Alessandro Fagagnini; Lorenzo Maria Zuccaro; Pietro Pitrone; Serena Dottori; Maurizio Porfirio; Ermenegildo de Ruvo; Ernesto Lioy |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2011-12-06 |
Journal Detail:
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Title: Circulation. Arrhythmia and electrophysiology Volume: 5 ISSN: 1941-3084 ISO Abbreviation: Circ Arrhythm Electrophysiol Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-15 Completed Date: 2012-04-17 Revised Date: 2012-05-24 |
Medline Journal Info:
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Nlm Unique ID: 101474365 Medline TA: Circ Arrhythm Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 22-31 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Policlinico Casilino, ASL Roma B, Rome, Italy. leonardo.calo@tin.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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physiopathology,
surgery* Catheter Ablation / methods* Denervation / methods* Electrocardiography Female Follow-Up Studies Heart Atria / innervation*, physiopathology Heart Conduction System / physiopathology, surgery* Humans Male Middle Aged Retrospective Studies Tachycardia, Paroxysmal / physiopathology, surgery* Treatment Outcome Vagus Nerve / physiopathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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