Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation

Carlo Pappone, Giuseppe Oreto, Salvatore Rosanio, Gabriele Vicedomini, Monica Tocchi, Filippo Gugliotta, Adriano Salvati, Cosimo Dicandia, Maria Pia Calabrò, Patrizio Mazzone, Eleonora Ficarra, Claudio Di Gioia, Simone Gulletta, Stefano Nardi, Vincenzo Santinelli, Stefano Benussi, Ottavio Alfieri

Research output: Contribution to journalArticlepeer-review

Abstract

Background - Circumferential radiofrequency ablation around pulmonary vein (PV) ostia has recently been described as a new anatomic approach for atrial fibrillation (AF). Methods and Results - 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 30 ms across the line. The amount of low-voltage encircled area was 3594±449 mm2, 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 (P

Original languageEnglish
Pages (from-to)2539-2544
Number of pages6
JournalCirculation
Volume104
Issue number21
Publication statusPublished - Nov 20 2001

Keywords

  • Ablation
  • Arrhythmia
  • Fibrillation
  • Mapping

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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