Basket-catheter-guided pulmonary vein isolation during distal PV pacing achieved elimination of bidirectional PV-LA conduction, with 80% of patients free of AF at 12 months.
Observational (n=50)
Does basket-catheter-guided pulmonary vein isolation eliminate bidirectional PV-LA conduction and prevent AF recurrence in patients with paroxysmal atrial fibrillation?
Basket-catheter-guided PV isolation is an effective approach for confirming bidirectional PV-LA conduction block, achieving 80% freedom from paroxysmal AF at 12 months.
BACKGROUND: Pulmonary vein (PV) isolation using a circular catheter creates an entrance block from the left atrium (LA) to the PV, which eliminates paroxysmal atrial fibrillation (PAF). A new approach to PV isolation during distal PV pacing is to use a basket catheter. METHODS AND RESULTS: Fifty consecutive patients with PAF underwent basket-catheter-guided PV isolation. PV pacing was performed from the distal electrode pair of the basket catheter. The exit breakthrough point was targeted for segmental PV isolation. The endpoint was the elimination of bidirectional PV - LA conduction. A repeat ablation procedure was performed in 12 of 14 patients who had recurrence of AF. The recovery of PV -LA conduction was noted in 24 of the 48 PVs, and 5 PVs (21%) had unidirectional block. At 12 months, 80% of patients were free of AF without antiarrhythmic drugs. No PV stenosis >50% was detected at 12 months after the procedure. CONCLUSIONS: This new approach for PV isolation during distal PV pacing using a basket catheter is useful for confirming bidirectional PV - LA conduction block. PV isolation that creates not only an entrance block but also an exit block at the PV - LA junction may be required to cure paroxysmal AF.
Kumagai et al. (Mon,) conducted a observational in Paroxysmal atrial fibrillation (n=50). Basket-catheter-guided pulmonary vein isolation was evaluated on Elimination of bidirectional PV - LA conduction and freedom from AF without antiarrhythmic drugs. Basket-catheter-guided pulmonary vein isolation during distal PV pacing achieved elimination of bidirectional PV-LA conduction, with 80% of patients free of AF at 12 months.