Left atrial catheter ablation for persistent AF resulted in 75% of patients maintaining normal sinus rhythm at 17 months, though most required concomitant antiarrhythmic drugs.
Observational (n=16)
Does left atrial catheter ablation combined with pulmonary vein isolation improve freedom from symptomatic atrial fibrillation in patients with drug-refractory persistent AF?
Left atrial catheter ablation combined with pulmonary vein isolation is effective for restoring and maintaining sinus rhythm in patients with persistent AF, though concomitant antiarrhythmic drug therapy is frequently required.
Background Segmental pulmonary vein (PV) isolation has been performed to eliminate paroxysmal atrial fibrillation (AF). However, this technique is not effective in most patients with persistent AF. Methods and Results Left atrial catheter ablation (LACA) was performed by encircling the left- and right-sided PV 1-2 cm from the ostia, guided by an electroanatomical mapping system in 16 patients with persistent AF (>1 month). Twelve patients (75%) had a history of unsuccessful transthoracic cardioversion and prophylactic antiarrhythmic drugs. Ablation lines were also created in the mitral isthmus and posterior LA. PV isolation was also performed for each PV if there were residual PV potentials after the LACA. After LACA, 38 PV (59%) were completely isolated, and complete PV isolation was achieved with only a few radiofrequency energy applications (2.7±2.0 min) on a narrow area of the PV ostium (24±15%) in the remaining PV. The mean procedure time was 200±38 min. During the follow-up period (17±3 months), 12 patients (75%) had normal sinus rhythm and were free of symptomatic AF with (n=10) or without antiarrhythmic drugs (n=2). One patient had a stroke just after the procedure. No other complications including PV narrowing (>50%) occurred. Conclusion This approach was effective in persistent AF, however, concomitant use of antiarrhythmic drugs was often required. (Circ J 2005; 69: 1057 - 1063)
Tada et al. (Sat,) conducted a observational in Persistent Atrial Fibrillation (n=16). Left atrial catheter ablation (LACA) was evaluated on Normal sinus rhythm and freedom from symptomatic AF. Left atrial catheter ablation for persistent AF resulted in 75% of patients maintaining normal sinus rhythm at 17 months, though most required concomitant antiarrhythmic drugs.
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