Contribution of the Posterior Left Atrium for the Maintenance of Atrial Fibrillation: Lessons from “Figure-of-Eight” Ablation

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  • Hara Motoki
    Department of Cardiology, Higashihiroshima Medical Center
  • Matsumoto Kazuo
    Department of Cardiology, Saitama Medical University, International Medical Center
  • Kato Ritsushi
    Department of Cardiology, Saitama Medical University, International Medical Center
  • Tobiume Takeshi
    Department of Cardiology, Saitama Medical University, International Medical Center
  • Ishida Hitoshi
    Department of Cardiology, Saitama Medical University, International Medical Center
  • Uenishi Masahiro
    Department of Cardiology, Saitama Medical University, International Medical Center
  • Sada Yoshiharu
    Department of Cardiology, Higashihiroshima Medical Center
  • Jo Hikari
    Department of Cardiology, Higashihiroshima Medical Center
  • Ono Yujiro
    Department of Cardiology, Higashihiroshima Medical Center
  • Yanagihara Kaoru
    Department of Cardiology, Higashihiroshima Medical Center

抄録

We recently proposed “figure-of-eight” pulmonary vein isolation (PVI) with the common posterior ablation line used for left and right PVI, which isolates the entire posterior left atrium (LA) and PV. In this study, AF termination rate during PVI was compared between the small ostial PVI and figure-of-eight PVI, thus the contribution of the posterior LA for the maintenance of AF was examined. Methods and Results: Small ostial PVI was performed in 69 paroxysmal (PAF), 37 persistent (PsAF) and 28 permanent AF (PmAF) patients. Figure-of-eight PVI was performed In 40 PAF, 27 PsAF and 9 PmAF patients. In PAF, sustained AF was terminated or organized in 46% by ostial PVI and 86% by figure-of-eight PVI (P<.05). The termination rate of PsAF was 19% by ostial and 49% by figure-of-eight PVI (P<.05). AF termination rate of PmAF was not significantly different between ostial (0%) and figure-of-eight PVI (11%). Conclusions: The posterior LA was important for the maintenance of AF in PAF and PsAF patients.

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