Document Detail


The effects of pulmonary vein isolation on the dominant frequency and organization of coronary sinus electrical activity during permanent atrial fibrillation.
MedLine Citation:
PMID:  17100672     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary vein isolation (PVI) has been shown to suppress atrial fibrillation (AF). We examined the effects of PVI on disorganization and dominant frequencies (DF) in patients with permanent AF. METHODS AND RESULTS: Twenty-eight patients with permanent AF (>6 months) who failed > or =1 antiarrhythmic drugs (AAD) and > or =2 cardioversions (CV) with AF reversion <30 minutes after CV were included. PVI and isolation of DFs in pulmonary veins (PVs) was performed during AF. Fast Fourier transformations of atrial electrograms were performed. Disorganization index (DI) was defined as the percentage of time spent in type III AF during 1-minute continuous recordings. The temporal stability and reproducibility of DIs from the same sites were verified over time prior to ablation. Highly disorganized AF activity concentrated in the posterior left atrium (PLA) including sites at the left atrial (PV-LA) junction (55.7% of sites in PLA, 32.9% in septum, and 11.4% in other sites). DF and DI from the coronary sinus (CS) before and after PVI were analyzed. PVI reduced the DI (14.3 +/- 25.0% before PVI vs 4.6 +/- 8.6% after PVI; P < 0.02). There was significant reduction of DI in 26 of 28 patients. The DF remained unchanged (5.6 +/- 1.3 Hz before PVI vs 5.9 +/- 0.9 Hz after PVI; P = 0.31). After a follow-up of 30 +/- 11 months, 15 (54%) of patients are free of symptomatic AF, 3 (10%) in sinus rhythm on AAD, 5 (18%) with paroxysmal AF, 4 (14%) in chronic AF, and 1 (4%) with atypical flutter. CONCLUSIONS: In the vast majority of patients with chronic AF, PVI reduces AF disorganization without affecting the DF as measured in the CS.
Authors:
Mehdi Razavi; Shulong Zhang; Scott Delapasse; Donghui Yang; Tomohiko Ai; Biswajit Kar; George Younis; Abdi Rasekh; Jie Cheng
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  29     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-14     Completed Date:  2007-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1201-8     Citation Subset:  IM    
Affiliation:
Texas Heart Institute/St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Action Potentials*
Atrial Fibrillation / physiopathology*,  surgery*
Coronary Vessels / physiopathology*
Electrocardiography / methods*
Female
Heart Conduction System / physiopathology*,  surgery*
Humans
Male
Middle Aged
Pulmonary Veins / physiopathology*

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


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