Document Detail

Electrophysiologically guided ablation of the pulmonary veins for the curative treatment of atrial fibrillation.
MedLine Citation:
PMID:  11028689     Owner:  NLM     Status:  MEDLINE    
Catheter ablation of triggers that induce paroxysms of atrial fibrillation (AF) is an emerging curative therapy for this most common of supraventricular arrhythmias. In a series of 225 consecutive patients with multidrug resistant AF, 96% of triggering foci originated from one or several pulmonary veins (PV) independent of ambient ectopy or structural heart disease. This article describes an ablation procedure that is guided by activation mapping tailored to each individual PV, including criteria to define an arrhythmogenic PV, the use of provocative manoeuvres, the role of circumferential mapping catheters to provide information on the extent, distribution and activation of PV muscle as well as the monitoring of distal PV potentials (PVP) during ablation. Radiofrequency ablation to eliminate distal PVPs is performed by targeting the proximal PVP during sinus rhythm (right PV) or left atrial pacing (left PV). This end-point predicts a successful outcome more often than acute ectopy suppression. Complete elimination of AF is presently achieved in 70% of the patients, resulting in the elimination of antiarrhythmic treatment and suspension of anticoagulant treatment. It is anticipated that continued technological development will improve and facilitate this technique of curative treatment of AF.
D C Shah; M Haïssaguerre; P Jaïs; M Hocini; T Yamane; I Deisenhofer; S Garrigue; J Clémenty
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of medicine     Volume:  32     ISSN:  0785-3890     ISO Abbreviation:  Ann. Med.     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2001-01-10     Completed Date:  2001-01-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8906388     Medline TA:  Ann Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  408-16     Citation Subset:  IM    
Hospital Haut-Lévêque, Bordeaux-Pessac, France.
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MeSH Terms
Atrial Fibrillation / physiopathology,  surgery*
Body Surface Potential Mapping
Catheter Ablation / methods*
Pulmonary Veins / physiopathology,  surgery*

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