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Local Coronary Flow is Associated with an Unsuccessful Complete Block line at the Mitral Isthmus in Patients with Atrial Fibrillation.
MedLine Citation:
PMID:  21984444     Owner:  NLM     Status:  Publisher    
BACKGROUND: -The addition of a mitral isthmus (MI) block line after pulmonary vein isolation (PVI) could lead to a favorable outcome of catheter ablation (CA) in patients with atrial fibrillation (AF). However, it is sometimes tough to create a complete MI block line, and the cooling effect because of the local coronary flow (LCF) may prevent the creation of a successful MI block line. METHODS AND RESULTS: -This study enrolled 81 AF patients in whom the creation of an MI block line was attempted in cases with persistent or pacing- inducible AF after PVI. A local coronary artery (LCA) across the MI block line was observed in 43/81 patients (53%), and bidirectional MI block was successfully accomplished in 53 of 81 (65%) patients at the estimated MI line. The ratio of a successful MI block line was significantly lower in the patients with an LCA than in those without (with an LCA; 42%, without an LCA; 92%, p<0.001). The mean diameter of the CS (0.59±0.18 vs. 0.82±0.22, p<0.001) and length of the estimated MI line (33.4±9.9 vs. 29.4±7.1, p=0.032) were significantly shorter in the patients with a successful MI block line than in those without. In the multivariable analysis, an LCA at the MI and larger CS diameter were independent risk factors for an unsuccessful MI block line. CONCLUSIONS: -LCF at the MI is associated with an increased incidence of an unsuccessful MI block line.
Toshiya Kurotobi; Yoshihisa Shimada; Naoto Kino; Katsuomi Iwakura; Koichi Inoue; Ryusuke Kimura; Yuko Tosyoshima; Hiroya Mizuno; Yuji Okuyama; Kenshi Fujii; Shinsuke Nanto; Issei Komuro
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-9
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 Shiroyama Hospital & Osaka University Graduate School of Medicine, Osaka, Japan;
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