Document Detail


Our Approach to Maximizing the Durability of Pulmonary Vein Isolation During a Paroxysmal Atrial Fibrillation Ablation Procedure.
MedLine Citation:
PMID:  22913515     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Maximizing Lesion Durability in PVI. Recurrence of atrial fibrillation (AF) after a single ablation procedure has been reported in the range of 15-60% depending on patient selection. A major factor leading to AF recurrence after catheter ablation therapy is electrical reconnection of one or more pulmonary veins (PVs) due to recovery of excitability of atrial tissue within ablation lesions. Maximizing the durability of pulmonary vein isolation (PVI) is critical to reduce recurrence rates and improve outcome after catheter treatment for AF. Strategies to increase the durability of the lesions include optimization of catheter contact by use of steerable sheaths, direct visualization by intracardiac ultrasound, and observation of the decrease in impedance at the beginning of ablation. Furthermore, currently achievable endpoints in addition to electrical PVI may reduce AF recurrence, such as identification of dormant conduction with adenosine administration and rendering the ablation line unexcitable to pacing. Integration of all these strategies into routine catheter ablation procedures for AF has reduced our AF recurrence rates and can easily be incorporated into practice without additional technological advances. (J Cardiovasc Electrophysiol, Vol. pp. 1-5).
Authors:
Tobias Reichlin; Gregory F Michaud
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-22
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Affiliation:
Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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