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Prevalence, Electrophysiological Properties, and Clinical Implications of Dissociated Pulmonary Vein Activity Following Pulmonary Vein Antrum Isolation.
MedLine Citation:
PMID:  21791333     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The objective of this study was to investigate the prevalence, electrophysiologic properties, and clinical implications of dissociated pulmonary vein (PV) activity after PV antrum isolation (PVAI) in patients with paroxysmal atrial fibrillation (AF). One hundred seventy-three consecutive patients (61 ±10 years old, 141 men) with drug-refractory paroxysmal AF who underwent AF ablation were analyzed. After identification of arrhythmogenic foci, PVAI was performed in all patients. Of the total 346 isolated ipsilateral PVs, 97 (28.0%) were silent, 35 (10.1%) demonstrated isolated ectopic beats, 209 (60.4%) demonstrated a regular ectopic rhythm, and 5 (1.4%) demonstrated fibrillatory activity. The culprit thoracic vein was identified in 77 patients (44.5%). After isolation of ipsilateral PVs, venous activity was observed in 68 (79.1%) and 178 (68.5%) PVs among the 86 PVs with AF triggers and 260 PVs without AF triggers, respectively (p = 0.06). There was no significant difference in the incidence of acute PV reconnections exposed by adenosine triphosphate between the 97 silent ipsilateral PVs and 209 ipsilateral PVs with dissociated PV activity after the PVAI (20.6% vs 19.1%, p = 0.78). After a mean follow-up of 48.7 ± 7.9 months there was no significant difference in rates of freedom from atrial tachyarrhythmias after a single procedure between patients with and those without dissociated activity (62.1% vs 63.3%, p = 0.74, log-rank test). In conclusion, although dissociated PV activity appearing after PV isolation is an important electrophysiologic finding to prove bidirectional conduction block between the left atrium and the PV during the procedure, the clinical implications might be limited.
Authors:
Shinsuke Miyazaki; Taishi Kuwahara; Atsushi Kobori; Yoshihide Takahashi; Asumi Takei; Akira Sato; Mitsuaki Isobe; Atsushi Takahashi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-24
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Cardiovascular Center, Yokosuka Kyosai Hospital, Yonegahamadori, Yokosuka-shi, Kanagawa-ken, Japan.
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