Catheter ablation of paroxysmal atrial fibrillation using a 3D mapping system

Carlo Pappone, Giuseppe Oreto, Filippo Lamberti, Gabriele Vicedomini, Maria Luisa Loricchio, Shlomo Shpun, Mariano Rillo, Maria Pia Calabrò, Andrea Conversano, Shlomo A. Ben-Haim, Riccardo Cappato, Sergio Chierchia

Research output: Contribution to journalArticle

Abstract

Background - We treated paroxysmal recurrent atrial fibrillation (AF) with radiofrequency (RF) catheter ablation by creating long linear lesions in the atria. To achieve line continuity, a 3D electroanatomic nonfluoroscopic mapping system was used. Methods and Results - In 27 patients with recurrent AF, a catheter incorporating a passive magnetic field sensor was navigated in both atria to construct a 3D activation map. RF energy was delivered to create continuous linear lesions: 3 lines (intercaval, isthmic, and anteroseptal) in the right atrium and a long line encircling the pulmonary veins in the left atrium. After RF application, the atria were remapped to validate completeness of the block lines, demonstrated by late activation of the areas circumscribed by the lines. The mean procedure duration was 312±103 minutes (range, 187 to 495), with mean fluoroscopy time of 107±44 minutes (range, 32 to 185 minutes). No acute complications occurred, but 1 patient experienced early prolonged sinus pauses and received a pacemaker. During the first day, 17 patients (63%) had AF episodes, but at discharge, 25 patients were in sinus rhythm. After a follow-up of 6.0 to 15.3 months (average, 10.5 ± 3.0 months), 16 patients are asymptomatic, 3 have an almost complete disappearance of symptoms, 1 patient is improved, and 7 patients have their AF attacks unchanged. Conclusions - Paroxysmal recurrent drug- refractory AF can be treated by RF catheter ablation. Creation of long continuous linear lesions necessary to compartmentalize the atria is facilitated by a nonfluoroscopic electroanatomic mapping system.

Original languageEnglish
Pages (from-to)1203-1208
Number of pages6
JournalCirculation
Volume100
Issue number11
Publication statusPublished - Sep 14 1999

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Keywords

  • Catheter ablation
  • Fibrillation
  • Mapping

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Pappone, C., Oreto, G., Lamberti, F., Vicedomini, G., Loricchio, M. L., Shpun, S., Rillo, M., Calabrò, M. P., Conversano, A., Ben-Haim, S. A., Cappato, R., & Chierchia, S. (1999). Catheter ablation of paroxysmal atrial fibrillation using a 3D mapping system. Circulation, 100(11), 1203-1208.