Document Detail


Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique.
MedLine Citation:
PMID:  16275866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary veins (PVs) can be completely isolated with continuous circular lesions (CCLs) around the ipsilateral PVs. However, electrophysiological findings have not been described in detail during ablation of persistent atrial fibrillation (AF). METHODS AND RESULTS: Forty patients with symptomatic persistent AF underwent complete isolation of the right-sided and left-sided ipsilateral PVs guided by 3D mapping and double Lasso technique during AF. Irrigated ablation was initially performed in the right-sided CCLs and subsequently in the left-sided CCLs. After complete isolation of both lateral PVs, stable sinus rhythm was achieved after AF termination in 12 patients; AF persisted and required cardioversion in 18 patients. In the remaining 10 patients, AF changed to left macroreentrant atrial tachycardia in 6 and common-type atrial flutter in 4 patients. All atrial tachycardias were successfully terminated during the procedure. Atrial tachyarrhythmias recurred in 15 of 40 patients at a median of 4 days after the initial ablation. A repeat ablation was performed at a median of 35 days after the initial procedure in 14 patients. During the repeat study, recovered PV conduction was found in 13 patients and successfully abolished by focal ablation of the conduction gap of the previous CCLs. After a mean of 8+/-2 months of follow-up, 38 (95%) of the 40 patients were free of AF. CONCLUSIONS: In patients with persistent AF, CCLs can result in either AF termination or conversion to macroreentrant atrial tachycardia in 55% of the patients. In addition, recovered PV conduction after the initial procedure is a dominant finding in recurrent atrial tachyarrhythmias and can be successfully abolished.
Authors:
Feifan Ouyang; Sabine Ernst; Julian Chun; Dietmar Bänsch; Yigang Li; Anselm Schaumann; Hercules Mavrakis; Xingpeng Liu; Florian T Deger; Boris Schmidt; Yumei Xue; Jiang Cao; Detlef Hennig; He Huang; Karl-Heinz Kuck; Matthias Antz
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Publication Detail:
Type:  Journal Article     Date:  2005-11-07
Journal Detail:
Title:  Circulation     Volume:  112     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-15     Completed Date:  2006-03-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3038-48     Citation Subset:  AIM; IM    
Affiliation:
II. Med. Abteilung, Allgemeines Krankenhaus St. Georg, Lohmühlenstrasse 5, 20099 Hamburg, Germany. Ouyangfeifan@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / physiopathology,  surgery*
Catheter Ablation*
Electric Countershock
Electrophysiology
Female
Follow-Up Studies
Functional Laterality
Humans
Male
Middle Aged
Prospective Studies
Treatment Outcome

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


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