TY - JOUR
T1 - Time courses and quantitative analysis of atrial fibrillation episode number and duration after circular plus linear left atrial lesions
T2 - Trigger elimination or substrate modification: Early or delayed cure?
AU - Kottkamp, Hans
AU - Tanner, Hildegard
AU - Kobza, Richard
AU - Schirdewahn, Petra
AU - Dorszewski, Anja
AU - Gerds-Li, Jin Hong
AU - Carbucicchio, Corrado
AU - Piorkowski, Christopher
AU - Hindricks, Gerhard
PY - 2004/8/18
Y1 - 2004/8/18
N2 - We sought to analyze the time course of atrial fibrillation (AF) episodes before and after circular plus linear left atrial ablation and the percentage of patients with complete freedom from AF after ablation by using serial seven-day electrocardiograms (ECGs). The curative treatment of AF targets the pathophysiological corner stones of AF (i.e., the initiating triggers and/or the perpetuation of AF). The pathophysiological complexity of both may not result in an all-or-nothing response but may modify number and duration of AF episodes. In patients with highly symptomatic AF, circular plus linear ablation lesions were placed around the left and right pulmonary veins, between the two circles, and from the left circle to the mitral annulus using the electroanatomic mapping system. Repetitive continuous 7-day ECGs administered before and after catheter ablation were used for rhythm follow-up. In 100 patients with paroxysmal (n = 80) and persistent (n = 20) AF, relative duration of time spent in AF significantly decreased over time (35 ± 37% before ablation, 26 ± 41% directly after ablation, and 10 ± 22% after 12 months). Freedom from AF stepwise increased in patients with paroxysmal AF and after 12 months measured at 88% or 74% depending on whether 24-h ECG or 7-day ECG was used. Complete pulmonary vein isolation was demonstrated in
AB - We sought to analyze the time course of atrial fibrillation (AF) episodes before and after circular plus linear left atrial ablation and the percentage of patients with complete freedom from AF after ablation by using serial seven-day electrocardiograms (ECGs). The curative treatment of AF targets the pathophysiological corner stones of AF (i.e., the initiating triggers and/or the perpetuation of AF). The pathophysiological complexity of both may not result in an all-or-nothing response but may modify number and duration of AF episodes. In patients with highly symptomatic AF, circular plus linear ablation lesions were placed around the left and right pulmonary veins, between the two circles, and from the left circle to the mitral annulus using the electroanatomic mapping system. Repetitive continuous 7-day ECGs administered before and after catheter ablation were used for rhythm follow-up. In 100 patients with paroxysmal (n = 80) and persistent (n = 20) AF, relative duration of time spent in AF significantly decreased over time (35 ± 37% before ablation, 26 ± 41% directly after ablation, and 10 ± 22% after 12 months). Freedom from AF stepwise increased in patients with paroxysmal AF and after 12 months measured at 88% or 74% depending on whether 24-h ECG or 7-day ECG was used. Complete pulmonary vein isolation was demonstrated in
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U2 - 10.1016/j.jacc.2004.04.049
DO - 10.1016/j.jacc.2004.04.049
M3 - Article
C2 - 15312874
AN - SCOPUS:4143070330
VL - 44
SP - 869
EP - 877
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 4
ER -