| Histopathologic characterization of chronic radiofrequency ablation lesions for pulmonary vein isolation. | |
| | |
MedLine Citation:
|
PMID: 22381429 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVES: This study describes the histopathologic and electrophysiological findings in patients with recurrence of atrial fibrillation (AF) after pulmonary vein (PV) isolation who underwent a subsequent surgical maze procedure. BACKGROUND: The recovery of PV conduction is commonly responsible for recurrence of AF after catheter-based PV isolation. METHODS: Twelve patients with recurrent AF after acutely successful catheter-based antral PV isolation underwent a surgical maze procedure. Full-thickness surgical biopsy specimens were obtained from the PV antrum in areas of visible endocardial scar. Before biopsy, intraoperative epicardial electrophysiological recordings were taken from each PV using a circular mapping catheter. RESULTS: Twenty-two PVs were biopsied from the 12 patients 8 ± 11 months after ablation. Eleven of the 22 specimens (50%) revealed transmural scar, and 11 (50%) showed viable myocardium with or without scar. Each biopsy specimen demonstrated evidence of injury, most commonly endocardial thickening (n = 21 [95%]) and fibrous scar (n = 18 [82%]). Seven of the 22 specimens (32%) showed conduction block at surgery. Transmural scar was more likely to be seen in the biopsy specimens from the PVs with conduction block than in specimens from the PVs showing reconnection. However, viable myocardium alone or mixed with scar was seen in 2 specimens from PVs with conduction block. CONCLUSIONS: PVs showing electrical reconnection after catheter-based antral ablation frequently reveal anatomic gaps or nontransmural lesions at the sites of catheter ablation. Nontransmural lesions are noted in some PVs with persistent conduction block, suggesting that lesion geometry may influence PV conduction. The histological findings show that nontransmural ablation can produce a dynamic cellular substrate with features of reversible injury. Delayed recovery from injury may explain late recurrences of AF after PV isolation. |
| | |
Authors:
|
Marcin Kowalski; Margaret M Grimes; Francisco J Perez; David N Kenigsberg; Jayanthi Koneru; Vigneshwar Kasirajan; Mark A Wood; Kenneth A Ellenbogen |
Related Documents
:
|
22437089 - Diagnosis of prostate cancer with needle biopsy: should all cases be biopsied before tr... 14569769 - Haemorrhagic lumbar synovial cyst. 22296879 - A case with unilateral hypoglossal nerve injury in branchial cyst surgery. 22536589 - Asymptomatic ossifying fibroma of the mandible: a case presentation. 22481289 - Malignant transformation of branch duct-type intraductal papillary mucinous neoplasms o... 22640429 - The horizon for treating cutaneous vascular lesions. 6245429 - The use of ultrasound in the evaluation of trophoblastic disease and its response to th... 17640229 - Immunostaining for mart-1 in the interpretation of problematic intra-epidermal pigmente... 17845619 - Malassezia spp. overgrowth in allergic cats. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 59 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2012 Mar |
Date Detail:
|
Created Date: 2012-03-02 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 930-8 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Clinical Cardiac Electrophysiology, Virginia Commonwealth University Medical Center, Richmond, Virginia. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The clinical impact of incomplete left atrial appendage closure with the Watchman Device in patients...
Next Document: Direct comparison of different stem cell types and subpopulations reveals superior paracrine potency...