Epicardial Atrial Mapping Can Predict Elimination of Chronic Atrial Fibrillation After the Box Pulmonary Vein Isolation During Mitral Valve Surgery

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著者

    • SUEDA Taijiro
    • Department of Cardiovascular Surgery, Hiroshima University School of Medicine
    • UCHIDA Naomichi
    • Department of Cardiovascular Surgery, Hiroshima University School of Medicine
    • TAKAHASHI Shinya
    • Department of Cardiovascular Surgery, Hiroshima University School of Medicine
    • TAKASAKI Taiichi
    • Department of Cardiovascular Surgery, Hiroshima University School of Medicine
    • KUROSAKI Tatsuya
    • Department of Cardiovascular Surgery, Hiroshima University School of Medicine
    • KATAYAMA Keijiro
    • Department of Cardiovascular Surgery, Hiroshima University School of Medicine
    • IMAI Katsuhiko
    • Department of Cardiovascular Surgery, Hiroshima University School of Medicine

抄録

Background: The pulmonary veins (PV) and posterior left atrium (LA) may contribute to the occurrence and maintenance of atrial fibrillation (AF). We evaluated whether simple epicardial electrophysiological mapping can predict elimination of chronic AF after the box PV isolation procedure. Methods and Results: Using a computerized 48-channel mapping system, we performed intraoperative atrial mapping in 16 patients with chronic AF associated with mitral valve (MV) disease. Patients' ages ranged from 48 to 76 years (mean, 61.4 years). AF duration ranged from 1 to 16 years (mean, 7.5 +/- 5.4 years). Simple box PV isolation was performed during the MV operation. Regular and repetitive activation was found in the LA of 12 of 16 patients, and irregular and chaotic activation was found in both atria in 4 of 16 patients; 12 patients with regular and repetitive activation of the LA were treated by box PV isolation and the other 4 patients with irregular and chaotic activation in both atria did not recover sinus rhythm after this procedure. AF-free rate was significantly higher in patients with regular and repetitive activation of the LA (P < 0.01). Conclusions: Box PV isolation was effective in the treatment of chronic AF associated with MV disease. Epicardial atrial mapping may predict elimination of AF after the box PV isolation. (Circ J 2012; 76: 852-859)

<b><i>Background:</i></b> The pulmonary veins (PV) and posterior left atrium (LA) may contribute to the occurrence and maintenance of atrial fibrillation (AF). We evaluated whether simple epicardial electrophysiological mapping can predict elimination of chronic AF after the box PV isolation procedure. <b><i>Methods and Results:</i></b> Using a computerized 48-channel mapping system, we performed intraoperative atrial mapping in 16 patients with chronic AF associated with mitral valve (MV) disease. Patients' ages ranged from 48 to 76 years (mean, 61.4 years). AF duration ranged from 1 to 16 years (mean, 7.5±5.4 years). Simple box PV isolation was performed during the MV operation. Regular and repetitive activation was found in the LA of 12 of 16 patients, and irregular and chaotic activation was found in both atria in 4 of 16 patients; 12 patients with regular and repetitive activation of the LA were treated by box PV isolation and the other 4 patients with irregular and chaotic activation in both atria did not recover sinus rhythm after this procedure. AF-free rate was significantly higher in patients with regular and repetitive activation of the LA (P<0.01). <b><i>Conclusions:</i></b> Box PV isolation was effective in the treatment of chronic AF associated with MV disease. Epicardial atrial mapping may predict elimination of AF after the box PV isolation. (<i>Circ J</i> 2012; <b>76:</b> 852-859)<br>

収録刊行物

  • Circulation journal : official journal of the Japanese Circulation Society

    Circulation journal : official journal of the Japanese Circulation Society 76(4), 852-859, 2012-03-25

    一般社団法人 日本循環器学会

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各種コード

  • NII論文ID(NAID)
    10030131060
  • NII書誌ID(NCID)
    AA11591968
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    13469843
  • データ提供元
    CJP書誌  IR  J-STAGE 
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