Document Detail


Efficacy of catheter ablation of atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy.
MedLine Citation:
PMID:  16500298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although pulmonary vein (PV) antrum isolation is effective in curing atrial fibrillation (AF) in a variety of heart diseases, results in patients with hypertrophic obstructive cardiomyopathy (HOCM) have not been reported. OBJECTIVES: The purpose of this study was to report the results and outcome of PV antrum isolation in patients with AF and HOCM. METHODS: Data from patients with AF and HOCM who underwent PV antrum isolation between February 2002 and May 2004 were analyzed retrospectively. An intracardiac echocardiographic-guided ablation technique with an 8-mm-tip catheter was used in all patients. Patients were followed in the outpatient clinic at 3, 6, and 12 months after ablation. RESULTS: Twenty-seven patients with AF and HOCM (mean age 55 +/- 10 years) underwent PV antrum isolation. Mean AF duration was 5.4 +/- 3.6 years. AF was paroxysmal in 14 (52%), persistent in 9 (33%), and permanent in 4 (15%). During a mean follow-up of 341 +/- 237 days, 13 patients (48%) had AF recurrence. Of these patients, five maintained sinus rhythm (SR) with antiarrhythmic drugs, one patient remained in persistent AF, and seven patients underwent a second PV antrum isolation. After the second PV antrum isolation, five patients remained in SR, giving a final success rate of 70% (19/27). Two patients had recurrence after second PV antrum isolation; one maintained SR with antiarrhythmic drugs and one remained in persistent AF. CONCLUSION: Compared with previously reported results in patients with lone AF, AF recurrence after the first PV antrum isolation is higher in patients with HOCM. However, after repeated ablation procedures, long-term cure can be achieved in a sizable number of patients. PV antrum isolation is a feasible therapeutic option in patients with AF and HOCM.
Authors:
Fethi Kilicaslan; Atul Verma; Eduardo Saad; Sakis Themistoclakis; Aldo Bonso; Antonio Raviele; Huseyin Bozbas; Michelle Williams Andrews; Salwa Beheiry; Steven Hao; Jennifer E Cummings; Nassir F Marrouche; Dhannunjaya Lakkireddy; Oussama Wazni; Hirosuke Yamaji; Luis C Saenz; Walid Saliba; Robert A Schweikert; Andrea Natale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  3     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-27     Completed Date:  2006-10-13     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  275-80     Citation Subset:  IM    
Affiliation:
Section of Pacing & Electrophysiology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / complications,  surgery*
Cardiomyopathy, Hypertrophic / complications,  surgery*
Catheter Ablation / methods*
Echocardiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Pulmonary Veins / surgery*
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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