Atrial Electroanatomic Remodeling After Circumferential Radiofrequency Pulmonary Vein Ablation

DOI Web Site 被引用文献30件
  • Carlo Pappone
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Giuseppe Oreto
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Salvatore Rosanio
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Gabriele Vicedomini
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Monica Tocchi
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Filippo Gugliotta
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Adriano Salvati
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Cosimo Dicandia
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Maria Pia Calabrò
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Patrizio Mazzone
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Eleonora Ficarra
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Claudio Di Gioia
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Simone Gulletta
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Stefano Nardi
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Vincenzo Santinelli
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Stefano Benussi
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).
  • Ottavio Alfieri
    From the Department of Cardiology, San Raffaele University Hospital, Milan, Italy; and the Department of Cardiology, University of Messina, Messina, Italy (G.O., M.P.C., E.F.).

書誌事項

タイトル別名
  • Efficacy of an Anatomic Approach in a Large Cohort of Patients With Atrial Fibrillation

抄録

<jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Background</jats:italic> </jats:bold> </jats:italic> </jats:bold> Circumferential radiofrequency ablation around pulmonary vein (PV) ostia has recently been described as a new anatomic approach for atrial fibrillation (AF). </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Methods and Results</jats:italic> </jats:bold> </jats:italic> </jats:bold> We treated 251 consecutive patients with paroxysmal (n=179) or permanent (n=72) AF. Circular PV lesions were deployed transseptally during sinus rhythm (n=124) or AF (n=127) using 3D electroanatomic guidance. Procedures lasted 148±26 minutes. Among 980 lesions surrounding individual PVs (n=956) or 2 ipsilateral veins with close openings or common ostium (n=24), 75% were defined as complete by a bipolar electrogram amplitude <0.1 mV inside the lesion and a delay >30 ms across the line. The amount of low-voltage encircled area was 3594±449 mm <jats:sup>2</jats:sup> , which accounted for 23±9% of the total left atrial (LA) map surface. Major complications (cardiac tamponade) occurred in 2 patients (0.8%). No PV stenoses were detected by transesophageal echocardiography. After 10.4±4.5 months, 152 patients with paroxysmal AF (85%) and 49 with permanent AF (68%) were AF-free. Patients with and without AF recurrence did not differ in age, AF duration, prevalence of heart disease, or ejection fraction, but the LA diameter was significantly higher ( <jats:italic>P</jats:italic> <0.001) in permanent AF patients with recurrence. The proportion of PVs with complete lesions was similar between patients with and without recurrence, but the latter had larger low-voltage encircled areas after radiofrequency (expressed as percent of LA surface area; <jats:italic>P</jats:italic> <0.001). </jats:p> <jats:p> <jats:bold> <jats:italic> <jats:bold> <jats:italic>Conclusions</jats:italic> </jats:bold> </jats:italic> </jats:bold> Circumferential PV ablation is a safe and effective treatment for AF. Its success is likely due to both PV trigger isolation and electroanatomic remodeling of the area encompassing the PV ostia. </jats:p>

収録刊行物

  • Circulation

    Circulation 104 (21), 2539-2544, 2001-11-20

    Ovid Technologies (Wolters Kluwer Health)

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