TY - JOUR
T1 - Circumferential Ablation With Pulmonary Vein Isolation in Permanent Atrial Fibrillation
AU - Cheema, Aamir
AU - Dong, Jun
AU - Dalal, Darshan
AU - Marine, Joseph E.
AU - Henrikson, Charles A.
AU - Spragg, David
AU - Cheng, Alan
AU - Nazarian, Saman
AU - Bilchick, Kenneth C.
AU - Almasry, Ibrahim
AU - Sinha, Sunil
AU - Scherr, Daniel
AU - Halperin, Henry
AU - Berger, Ronald
AU - Calkins, Hugh
PY - 2007/5/15
Y1 - 2007/5/15
N2 - Each of the main approaches to catheter ablation of atrial fibrillation (AF, segmental and circumferential) is associated with limited efficacy in patients with permanent AF. The objective is to report outcomes of circumferential ablation with pulmonary vein (PV) isolation, determined using a circular mapping catheter, in patients with permanent AF and determine relations between the duration of permanent AF and efficacy. The patient population was composed of 41 consecutive patients (34 men; age 58 ± 11 years) with permanent AF who underwent radiofrequency catheter ablation through circumferential ablation with PV isolation. They were in permanent AF for 2.3 ± 3.6 years, and 3.4 ± 2.2 cardioversion procedures and 1.9 ± 0.8 class I/III antiarrhythmic drugs had failed. After a follow-up of 11 ± 2 months, the single-procedure success rate was 36% (n = 15) with an additional 12% (n = 5) showing improvement. With repeat procedures in 19%, the success rate was 54% (n = 22) with an additional 12% (n = 5) showing improvement. All patients who underwent repeat ablations had recovered PV conduction. Single-procedure success was higher in patients who were in permanent AF for ≤1 year compared with those in permanent AF for >1 year (50% vs 20%, respectively, p = 0.05). A major complication occurred in 4 patients (8%), including 3 patients with vascular complications and 1 with stroke. In conclusion, study results suggest that circumferential ablation with PV isolation has moderate efficacy in patients with permanent AF. Efficacy is limited in those in continuous AF for >12 months.
AB - Each of the main approaches to catheter ablation of atrial fibrillation (AF, segmental and circumferential) is associated with limited efficacy in patients with permanent AF. The objective is to report outcomes of circumferential ablation with pulmonary vein (PV) isolation, determined using a circular mapping catheter, in patients with permanent AF and determine relations between the duration of permanent AF and efficacy. The patient population was composed of 41 consecutive patients (34 men; age 58 ± 11 years) with permanent AF who underwent radiofrequency catheter ablation through circumferential ablation with PV isolation. They were in permanent AF for 2.3 ± 3.6 years, and 3.4 ± 2.2 cardioversion procedures and 1.9 ± 0.8 class I/III antiarrhythmic drugs had failed. After a follow-up of 11 ± 2 months, the single-procedure success rate was 36% (n = 15) with an additional 12% (n = 5) showing improvement. With repeat procedures in 19%, the success rate was 54% (n = 22) with an additional 12% (n = 5) showing improvement. All patients who underwent repeat ablations had recovered PV conduction. Single-procedure success was higher in patients who were in permanent AF for ≤1 year compared with those in permanent AF for >1 year (50% vs 20%, respectively, p = 0.05). A major complication occurred in 4 patients (8%), including 3 patients with vascular complications and 1 with stroke. In conclusion, study results suggest that circumferential ablation with PV isolation has moderate efficacy in patients with permanent AF. Efficacy is limited in those in continuous AF for >12 months.
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U2 - 10.1016/j.amjcard.2006.12.073
DO - 10.1016/j.amjcard.2006.12.073
M3 - Article
C2 - 17493473
AN - SCOPUS:34247626090
SN - 0002-9149
VL - 99
SP - 1425
EP - 1428
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 10
ER -