Complete isolation of the pulmonary veins and posterior left atrium in chronic atrial fibrillation. Long-term clinical outcome

113Citations
Citations of this article
59Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

Aims: To evaluate the contribution of the posterior left atrium (LA) to chronic atrial fibrillation (AF). Methods and results: Twenty-seven patients with chronic-AF were studied. After pulmonary vein (PV) isolation, the posterior-LA was isolated by ablation joining the right- and left-PVs using an irrigated-tip catheter. Isolation was demonstrated by absent/dissociated posterior-LA activity and the inability to pace the region. Ablation impact was determined by the effect on cycle length (CL) and AF termination. Posterior-LA isolation was achieved using 35 ± 12 min of radiofrequency with total fluoroscopic and procedural durations of 64 ± 16 and 199 ± 46 min, resulting in abolition of electrograms (n = 21) or autonomous activity (n = 6; CL 820 ± 343 ms). AFCL increased from 156 ± 28 ms to 162 ± 27 ms with PV-isolation and to 175 ± 32 ms by posterior-LA exclusion (P < 0.0001). AF persisted in all after PV-isolation and terminated in 5 (19%) during posterior-LA-isolation. After 10 ± 6 months, 12 patients developed atrial tachycardia (four) or AF (eight); four underwent repeat posterior-LA-isolation, while the others required additional ablation/antiarrhythmics. After 21 ± 5 months, 17 (63%) were in sinus rhythm following posterior-LA-isolation. Conclusion: This study demonstrates the feasibility of complete posterior-LA exclusion by catheter ablation. This strategy results in maintenance of sinus rhythm in 63% at ∼2 years follow-up. © The European Society of Cardiology 2007. All rights reserved.

Cite

CITATION STYLE

APA

Sanders, P., Hocini, M., Jaïs, P., Sacher, F., Hsu, L. F., Takahashi, Y., … Haïssaguerre, M. (2007). Complete isolation of the pulmonary veins and posterior left atrium in chronic atrial fibrillation. Long-term clinical outcome. European Heart Journal, 28(15), 1862–1871. https://doi.org/10.1093/eurheartj/ehl548

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free