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- Title
Long-Term Safety and Efficacy of Circumferential Ablation with Pulmonary Vein Isolation.
- Authors
CHEEMA, AAMIR; DONG, JUN; DALAL, DARSHAN; VASAMREDDY, CHANDRASEKHAR R.; MARINE, JOSEPH E.; HENRIKSON, CHARLES A.; SPRAGG, DAVID; CHENG, ALAN; NAZARIAN, SAMAN; SINHA, SUNIL; HALPERIN, HENRY; BERGER, RONALD; CALKINS, HUGH
- Abstract
Background: Each of the two main approaches to catheter ablation of atrial fibrillation (AF, segmental and circumferential) is associated with moderate long-term efficacy. Objective: To report the long-term outcomes of a modified technique that combines circumferential ablation with pulmonary vein (PV) isolation, determined by a circular mapping catheter and to determine the relationship between complete PV isolation and long-term efficacy. Methods: The patient population was composed of 64 consecutive patients (47 men [73%]; age 59 ± 11 years) with AF who underwent catheter ablation. AF was paroxysmal in 29 (45%) and nonparoxysmal in 35 (55%). Each patient was followed for a minimum of 12 months. Results: After a mean follow-up of 13 ± 1 months, the long-term single-procedure success rate was 45% (n = 29) with an additional 4% (n = 3) of patients demonstrating improvement. With repeat procedures in 19 patients, the overall long-term success rate was 62% (n = 40) with 9% (n = 6) demonstrating improvement. All the patients who underwent repeat ablations had recovered PV conduction. Incomplete PV isolation was the only independent predictor of failure. A major complication occurred in four (6%) patients, including three patients with vascular complications and one with cardiac tamponade. Conclusion: Our results suggest that the long-term single-procedure efficacy of circumferential ablation with PV isolation in a cohort of patients with predominantly nonparoxysmal AF approaches 50%. Repeat procedures involving re-isolation of the PVs result in a significant improvement in outcomes. Complete electrical isolation of the PVs has a significant impact on the long-term efficacy of the procedure.
- Subjects
CATHETER ablation; ATRIAL fibrillation; ATRIAL arrhythmias; PULMONARY veins; PULMONARY blood vessels; CATHETERIZATION; ELECTROSURGERY
- Publication
Journal of Cardiovascular Electrophysiology, 2006, Vol 17, Issue 10, p1080
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/j.1540-8167.2006.00569.x