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Substrate Modification by Pulmonary Vein Isolation and Left Atrial Linear Ablation in Patients with Persistent Atrial Fibrillation: Its Impact on Complex-Fractionated Atrial Electrograms.
MedLine Citation:
PMID:  22487602     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PV and Linear Ablation for CFAEs. Introduction: Linear ablations in the left atrium (LA), in addition to pulmonary vein (PV) isolation, have been demonstrated to be an effective ablation strategy in patients with persistent atrial fibrillation (PsAF). This study investigated the impact of LA linear ablation on the complex-fractionated atrial electrograms (CFAEs) of PsAF patients. Methods and Results: A total of 40 consecutive PsAF patients (age: 54 ± 10 years, 39 males) who underwent catheter ablation were enrolled in this study. Linear ablation of both roofline between the right and left superior PVs and the mitral isthmus line joining from the mitral annulus to the left inferior PV were performed following PV isolation during AF. High-density automated CFAE mapping was performed using the NAVX, and maps were obtained 3 times during the procedure (prior to ablation, after PV isolation, and after linear ablations) and were compared. PsAF was terminated by ablation in 13 of 40 patients. The mean total LA surface area and baseline CFAEs area were 120.8 ± 23.6 and 88.0 ± 23.5 cm(2) (74.2%), respectively. After PV isolation and linear ablations in the LA, the area of CFAEs area was reduced to 71.6 ± 22.6 cm(2) (58.7%) (P < 0.001) and 44.9 ± 23.0 cm(2) (39.2%) (P < 0.001), respectively. The LA linear ablations resulted in a significant reduction of the CFAEs area percentage in the region remote from ablation sites (from 56.3 ± 20.6 cm(2) (59.6%) to 40.4 ± 16.5 cm(2) (42.9%), P < 0.0001). Conclusion: Both PV isolation and LA linear ablations diminished the CFAEs in PsAF patients, suggesting substrate modification by PV and linear ablations. (J Cardiovasc Electrophysiol, Vol. pp. 1-8).
Authors:
Seiichiro Matsuo; Teiichi Yamane; Taro Date; Ken-Ichi Tokutake; Mika Hioki; Ryohsuke Narui; Keiichi Ito; Shin-Ichi Tanigawa; Seigo Yamashita; Michifumi Tokuda; Keiichi Inada; Satoshi Arase; Hidenori Yagi; Ken-Ichi Sugimoto; Michihiro Yoshimura
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-9
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-10     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:
Department of Cardiology, The Jikei University School of Medicine, Nishi-shinbashi, Minato-ku, Tokyo, Japan.
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