| Efficacy of repeat pulmonary vein isolation procedures in patients with recurrent atrial fibrillation. | |
| | |
MedLine Citation:
|
PMID: 15363079 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
INTRODUCTION: Pulmonary vein (PV) isolation is effective in the treatment of most patients with atrial fibrillation (AF). Some advocate the addition of linear ablation techniques to improve efficacy; however, previous studies suggest recurrent PV conduction is responsible for AF recurrence. The aim of this study was to determine the effectiveness of repeat PV isolation in patients with recurrent AF after an initial ablation procedure and to determine if any patient characteristics predict failure of repeat PV isolation procedures. METHODS AND RESULTS: Seventy-four patients with two or more AF ablation procedures using selective PV isolation were included. PV isolation was guided with multielectrode ring catheter recordings, electroanatomic mapping, and intracardiac electrocardiography. Radiofrequency energy was delivered using a 4-mm-tip catheter (maximum 40 W, 52 degrees C); cooled-tip ablation was performed in 10 patients. Linear ablation was not performed. Antiarrhythmic drugs were continued for at least 6 weeks after ablation; AF episodes during this period were censored. Reconnection of one or more segments of previously ablated PVs was observed in 97% of patients; reconnected PVs served as the trigger for AF in 77%. Repeat PV isolation resulted in AF control (cure or 90% reduction in AF episodes) in 64 patients (86%) over a follow-up period of 9.1 +/- 6.7 months. "High-risk" characteristics such as left atrial enlargement, persistent AF, or mitral regurgitation did not predict failure of repeat PV isolation procedures. CONCLUSION: Recurrent AF following selective PV isolation is overwhelmingly associated with PV electrical reconnection. Repeat PV isolation without linear ablation provides effective treatment for recurrent AF in patients in whom an initial PV isolation procedure failed, independent of clinical characteristics. |
| | |
Authors:
|
David J Callans; Edward P Gerstenfeld; Sanjay Dixit; Erica Zado; Mark Vanderhoff; Jian-Fang Ren; Francis E Marchlinski |
Related Documents
:
|
20466519 - Systemic inflammation and left atrial thrombus in patients with non-rheumatic atrial fi... 18065789 - Preventing haemodialysis catheter-related bacteraemia with an antimicrobial lock soluti... 11954709 - Measure of synchronisation of right atrial depolarisation wavefronts during atrial fibr... 15529259 - Time to virological failure of 3 classes of antiretrovirals after initiation of highly ... 7845789 - Initial experience with mode switching in a dual sensor, dual chamber pacemaker in pati... 20639109 - Direction-dependent conduction in lone atrial fibrillation. 3335709 - Diastolic mitral and tricuspid regurgitation by doppler echocardiography in patients wi... 16103629 - Multidrug resistance as a potential prognostic indicator in acute myeloid leukemia with... 21965849 - Utility of dermoscopy in alopecia areata. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of cardiovascular electrophysiology Volume: 15 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2004 Sep |
Date Detail:
|
Created Date: 2004-09-14 Completed Date: 2005-02-08 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1050-5 Citation Subset: IM |
Affiliation:
|
Electrophysiology Section, Division of Cardiology, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. david.callans@uphs.upenn.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Atrial Fibrillation
/
surgery*,
ultrasonography Body Surface Potential Mapping Catheter Ablation Echocardiography Electrophysiology Female Humans Male Middle Aged Prospective Studies Pulmonary Veins / surgery*, ultrasonography Reoperation Treatment Failure Treatment Outcome* |
| Comments/Corrections | |
Comment In:
|
J Cardiovasc Electrophysiol. 2004 Sep;15(9):1056-7
[PMID:
15363080
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: "Dormant" pulmonary vein conduction revealed by adenosine after ostial radiofrequency cath...
Next Document: Comparison of efficacy of reverse remodeling and clinical improvement for relatively narrow and wide...