Document Detail

Mechanisms of recurrent atrial fibrillation: comparisons between segmental ostial versus circumferential pulmonary vein isolation.
MedLine Citation:
PMID:  17504254     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Electrical isolation of pulmonary veins (PVs) is an effective therapy for atrial fibrillation (AF). Both segmental ostial PV ablation and circumferential ablation with PV-left atrial (LA) block have been implicated to eliminate AF. However, the mechanism of the recurrent AF after undergoing either strategy remains unclear. METHODS AND RESULTS: Of the 73 consecutive patients with symptomatic AF that underwent PV isolation and had recurrences of AF, Group 1 consisted of 46 patients (age 56 +/- 13 years old, 35 males) who underwent PV isolation by segmental ostial PV ablation and Group 2 consisted of 27 patients (age 51 +/- 11 years old, 24 males) who underwent circumferential ablation with PV-LA block. In Group 1, the earliest ectopic beat or ostial PV potentials were targeted. In Group 2, circumferential ablation with PV-LA block was performed by encircling the extraostial regions around the left and right PVs. During the first procedure, all patients had PV-AF. There was no difference in the non-PV ectopy between Group 1 and Group 2. During the second procedure, the incidence of an LA posterior wall ectopy initiating AF was significantly lower (20% vs. 0%, P = 0.01) in Group 2. There was no difference in the PV ectopy initiating AF during the second procedure. CONCLUSION: Circumferential ablation of AF with PV-LA block may eliminate the LA posterior wall ectopy and decrease the incidence of LA posterior wall ectopy initiating AF during the second procedure.
Li-Wei Lo; Ching-Tai Tai; Yenn-Jiang Lin; Shih-Lin Chang; Wanwarang Wongcharoen; Ming-Hsiung Hsieh; Ta-Chuan Tuan; Ameya R Udyavar; Yu-Feng Hu; Yi-Jen Chen; Hsuan-Ming Tsao; Shih-Ann Chen
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2007-05-14
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  18     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-26     Completed Date:  2007-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  803-7     Citation Subset:  IM    
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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MeSH Terms
Atrial Fibrillation / surgery*
Catheter Ablation / methods*
Middle Aged
Pulmonary Veins / surgery*
Recurrence / prevention & control*
Reoperation / methods
Treatment Outcome

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

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