Abstract
Introduction: There is limited information describing late changes in the electroanatomic characteristics of the left atrium (LA) associated with recurrence after an anatomical circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF). Methods and Results: Forty-seven patients (57 ± 8 years) undergoing a repeat ablation after CPVA were included. Using an electroanatomic mapping system, we measured the bipolar voltage by averaging points in the pulmonary vein (PV)-LA junction and four other LA sites. Conduction velocity and AF cycle length (AFCL) were also measured and the results are compared with the first procedure. After an initial decrease observed at the end of the first procedure, voltage and conduction velocity returned to intermediate values in all LA sites, with lower voltage at the LIPV antrum (P = 0.004), and lower conduction velocity across the LIPV and RSPV (P <0.001). Conduction gaps were more prevalent at the septal aspect of the right PV encircling lines (85%), between the left atrial appendage (LAA) and the LSPV (70%) and lines at the posterior wall (71%). There was a nonsignificant increase in AFCL, with a more widespread distribution of organized electrograms (32.4% vs 46.6%). Conclusion: Recurrence after CPVA is associated with a reverse process of voltage and conduction velocity increase across ablated areas, especially the PV-LA junction, and is related to the presence of conduction gaps, which are distributed mostly at the septal aspect of the lines encircling the right PVs and at the LAA-LSPV area. Organization of atrial electrograms seen during AF ablation is maintained at a repeat procedure.
| Original language | English |
|---|---|
| Pages (from-to) | 1279-1285 |
| Number of pages | 7 |
| Journal | Journal of Cardiovascular Electrophysiology |
| Volume | 17 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2006 |
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Keywords
- Ablation
- Atrial fibrillation
- Recurrence
- Remodeling
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology
Cite this
Electroanatomic remodeling of the left atrium in patients undergoing repeat pulmonary vein ablation : Mechanistic insights and implications for ablation. / Mesas, Cézar Eumann; Augello, Giuseppe; Edward Lang, Christopher Charles; Gugliotta, Filippo; Vicedomini, Gabriele; Sora, Nicoleta; De Paola, Angelo Amato Vincenzo; Pappone, Carlo.
In: Journal of Cardiovascular Electrophysiology, Vol. 17, No. 12, 12.2006, p. 1279-1285.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Electroanatomic remodeling of the left atrium in patients undergoing repeat pulmonary vein ablation
T2 - Mechanistic insights and implications for ablation
AU - Mesas, Cézar Eumann
AU - Augello, Giuseppe
AU - Edward Lang, Christopher Charles
AU - Gugliotta, Filippo
AU - Vicedomini, Gabriele
AU - Sora, Nicoleta
AU - De Paola, Angelo Amato Vincenzo
AU - Pappone, Carlo
PY - 2006/12
Y1 - 2006/12
N2 - Introduction: There is limited information describing late changes in the electroanatomic characteristics of the left atrium (LA) associated with recurrence after an anatomical circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF). Methods and Results: Forty-seven patients (57 ± 8 years) undergoing a repeat ablation after CPVA were included. Using an electroanatomic mapping system, we measured the bipolar voltage by averaging points in the pulmonary vein (PV)-LA junction and four other LA sites. Conduction velocity and AF cycle length (AFCL) were also measured and the results are compared with the first procedure. After an initial decrease observed at the end of the first procedure, voltage and conduction velocity returned to intermediate values in all LA sites, with lower voltage at the LIPV antrum (P = 0.004), and lower conduction velocity across the LIPV and RSPV (P <0.001). Conduction gaps were more prevalent at the septal aspect of the right PV encircling lines (85%), between the left atrial appendage (LAA) and the LSPV (70%) and lines at the posterior wall (71%). There was a nonsignificant increase in AFCL, with a more widespread distribution of organized electrograms (32.4% vs 46.6%). Conclusion: Recurrence after CPVA is associated with a reverse process of voltage and conduction velocity increase across ablated areas, especially the PV-LA junction, and is related to the presence of conduction gaps, which are distributed mostly at the septal aspect of the lines encircling the right PVs and at the LAA-LSPV area. Organization of atrial electrograms seen during AF ablation is maintained at a repeat procedure.
AB - Introduction: There is limited information describing late changes in the electroanatomic characteristics of the left atrium (LA) associated with recurrence after an anatomical circumferential pulmonary vein ablation (CPVA) for atrial fibrillation (AF). Methods and Results: Forty-seven patients (57 ± 8 years) undergoing a repeat ablation after CPVA were included. Using an electroanatomic mapping system, we measured the bipolar voltage by averaging points in the pulmonary vein (PV)-LA junction and four other LA sites. Conduction velocity and AF cycle length (AFCL) were also measured and the results are compared with the first procedure. After an initial decrease observed at the end of the first procedure, voltage and conduction velocity returned to intermediate values in all LA sites, with lower voltage at the LIPV antrum (P = 0.004), and lower conduction velocity across the LIPV and RSPV (P <0.001). Conduction gaps were more prevalent at the septal aspect of the right PV encircling lines (85%), between the left atrial appendage (LAA) and the LSPV (70%) and lines at the posterior wall (71%). There was a nonsignificant increase in AFCL, with a more widespread distribution of organized electrograms (32.4% vs 46.6%). Conclusion: Recurrence after CPVA is associated with a reverse process of voltage and conduction velocity increase across ablated areas, especially the PV-LA junction, and is related to the presence of conduction gaps, which are distributed mostly at the septal aspect of the lines encircling the right PVs and at the LAA-LSPV area. Organization of atrial electrograms seen during AF ablation is maintained at a repeat procedure.
KW - Ablation
KW - Atrial fibrillation
KW - Recurrence
KW - Remodeling
UR - http://www.scopus.com/inward/record.url?scp=33751338457&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33751338457&partnerID=8YFLogxK
U2 - 10.1111/j.1540-8167.2006.00654.x
DO - 10.1111/j.1540-8167.2006.00654.x
M3 - Article
C2 - 17081209
AN - SCOPUS:33751338457
VL - 17
SP - 1279
EP - 1285
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 12
ER -