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January 1, 2003Circulation JournalOpen Access

Treatment of Paroxysmal Atrial Fibrillation by Pulmonary Vein Isolation

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Key result

Pulmonary veins play a critical role in the generation of atrial fibrillation, providing the pathophysiological basis for pulmonary vein isolation in treating paroxysmal atrial fibrillation.

Why the study?

Does pulmonary vein isolation prevent recurrent atrial fibrillation in patients with paroxysmal or persistent AF?

Population

196 consecutive patients, mean age 52±11 years, 13% with underlying structural heart disease, mean LVEF…

Design

Case_series

Follow-up

24 months

Authors

FMFred MoradyElectrophysiology

Discussion

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Implication

Supports PVI for paroxysmal AF; leaves open efficacy questions in persistent AF pending higher-level evidence.

Structured PICO

Does pulmonary vein isolation prevent recurrent atrial fibrillation in patients with paroxysmal or persistent AF?

P
Population
196 consecutive patients (176 with paroxysmal AF, 20 with persistent AF), mean age 52±11 years, 13% with underlying structural heart disease, mean LVEF 0.55±0.04, mean left atrial diameter 40±5 mm, treated at the University of Michigan.
I
Intervention
Pulmonary vein isolation by segmental ostial applications of radiofrequency energy (target temperature 52°C, maximum power output 35W for 20-40s) guided by pulmonary vein potentials.
O
Outcome
Freedom from recurrent atrial fibrillation in the absence of antiarrhythmic drug therapy at 12 and 24 monthshard clinical

Pulmonary vein isolation by segmental ostial ablation is highly effective for maintaining sinus rhythm in paroxysmal atrial fibrillation but has low efficacy in persistent atrial fibrillation.

Cite This Study

Fred Morady (2003) studied this question. Pulmonary veins play a critical role in the generation of atrial fibrillation, providing the pathophysiological basis for pulmonary vein isolation in treating paroxysmal atrial fibrillation.

synapsesocial.com/papers/6a154aef5347fbb1739f8b90https://doi.org/10.1253/circj.67.567

Topics

Atrial fibrillationPersistent AF managementAF ablation outcomesAnticoagulation in AF
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Segmental Ostial Ablation to Isolate the Pulmonary Veins During Atrial Fibrillation2002 · 245 citations
  2. 2Electrophysiologically guided ablation of the pulmonary veins for the curative treatment of atrial fibrillation2000 · 59 citations
  3. 3Initiation of Atrial Fibrillation by Ectopic Beats Originating From the Pulmonary Veins1999 · 1,467 citations
  4. 4Thoracic veins and the mechanisms of non-paroxysmal atrial fibrillation2002 · 69 citations
  5. 5Atrial Electroanatomic Remodeling After Circumferential Radiofrequency Pulmonary Vein Ablation2001 · 866 citations