Circumferential Ablation With Pulmonary Vein Isolation in Permanent Atrial Fibrillation

Aamir Cheema, Jun Dong, Darshan Dalal, Joseph E. Marine, Charles Henrikson, David Spragg, Alan Cheng, Saman Nazarian, Kenneth C. Bilchick, Ibrahim Almasry, Sunil Sinha, Daniel Scherr, Henry Halperin, Ronald Berger, Hugh Calkins

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1425-1428
Number of pages4
JournalAmerican Journal of Cardiology
Volume99
Issue number10
DOIs
StatePublished - May 15 2007
Externally publishedYes

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Pulmonary Veins
Atrial Fibrillation
Catheter Ablation
Electric Countershock
Anti-Arrhythmia Agents
Blood Vessels
Catheters
Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Circumferential Ablation With Pulmonary Vein Isolation in Permanent Atrial Fibrillation. / Cheema, Aamir; Dong, Jun; Dalal, Darshan; Marine, Joseph E.; Henrikson, Charles; Spragg, David; Cheng, Alan; Nazarian, Saman; Bilchick, Kenneth C.; Almasry, Ibrahim; Sinha, Sunil; Scherr, Daniel; Halperin, Henry; Berger, Ronald; Calkins, Hugh.

In: American Journal of Cardiology, Vol. 99, No. 10, 15.05.2007, p. 1425-1428.

Research output: Contribution to journalArticle

Cheema, A, Dong, J, Dalal, D, Marine, JE, Henrikson, C, Spragg, D, Cheng, A, Nazarian, S, Bilchick, KC, Almasry, I, Sinha, S, Scherr, D, Halperin, H, Berger, R & Calkins, H 2007, 'Circumferential Ablation With Pulmonary Vein Isolation in Permanent Atrial Fibrillation', American Journal of Cardiology, vol. 99, no. 10, pp. 1425-1428. https://doi.org/10.1016/j.amjcard.2006.12.073
Cheema, Aamir ; Dong, Jun ; Dalal, Darshan ; Marine, Joseph E. ; Henrikson, Charles ; Spragg, David ; Cheng, Alan ; Nazarian, Saman ; Bilchick, Kenneth C. ; Almasry, Ibrahim ; Sinha, Sunil ; Scherr, Daniel ; Halperin, Henry ; Berger, Ronald ; Calkins, Hugh. / Circumferential Ablation With Pulmonary Vein Isolation in Permanent Atrial Fibrillation. In: American Journal of Cardiology. 2007 ; Vol. 99, No. 10. pp. 1425-1428.
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AU - Nazarian, Saman

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AU - Berger, Ronald

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