OBJECTIVE: To investigate the feasibility of catheter ablation as a treatment for symptomatic patients with longstanding permanent atrial fibrillation (AF). METHODS: Radiofrequency ablation was applied to encircle all pulmonary veins (PVs) and create lines from the left inferior PV to the mitral valve, along the roof of the left atrium between the PVs, and along the tricuspid valve-inferior vena cava isthmus. A seven day Holter was recorded at discharge and at follow up to assess arrhythmia burden. If patients developed a symptomatic, sustained atrial arrhythmia a repeat ablation procedure was advised. RESULTS: 42 patients underwent the procedure that took a mean of five hours with 50 minutes of fluoroscopy. After a median follow up of 8.4 months, 31 of 41 surviving patients (76%) were in sinus rhythm. Of these, 29 patients were no longer taking any antiarrhythmic drugs but 22 (52%) required more than one procedure. During follow up 49% experienced a sustained atrial tachycardia. Twenty six repeat procedures were performed. Maintenance of sinus rhythm after the first, second, or third procedure was 36% (15 of 42), 58% (11 of 19), and 71% (5 of 7), respectively. From a total of 68 procedures there were two serious complications (2.9%): a stroke from which a full recovery was made, and a PV stenosis. CONCLUSION: Catheter ablation can be used to cure longstanding permanent AF; however, there is a significant complication rate. Whether this is offset by a mortality benefit associated with sinus rhythm is unknown. Many patients will need more than one procedure to achieve success.
OBJECTIVE: To investigate the feasibility of catheter ablation as a treatment for symptomatic patients with longstanding permanent atrial fibrillation (AF). METHODS: Radiofrequency ablation was applied to encircle all pulmonary veins (PVs) and create lines from the left inferior PV to the mitral valve, along the roof of the left atrium between the PVs, and along the tricuspid valve-inferior vena cava isthmus. A seven day Holter was recorded at discharge and at follow up to assess arrhythmia burden. If patients developed a symptomatic, sustained atrial arrhythmia a repeat ablation procedure was advised. RESULTS: 42 patients underwent the procedure that took a mean of five hours with 50 minutes of fluoroscopy. After a median follow up of 8.4 months, 31 of 41 surviving patients (76%) were in sinus rhythm. Of these, 29 patients were no longer taking any antiarrhythmic drugs but 22 (52%) required more than one procedure. During follow up 49% experienced a sustained atrial tachycardia. Twenty six repeat procedures were performed. Maintenance of sinus rhythm after the first, second, or third procedure was 36% (15 of 42), 58% (11 of 19), and 71% (5 of 7), respectively. From a total of 68 procedures there were two serious complications (2.9%): a stroke from which a full recovery was made, and a PV stenosis. CONCLUSION: Catheter ablation can be used to cure longstanding permanent AF; however, there is a significant complication rate. Whether this is offset by a mortality benefit associated with sinus rhythm is unknown. Many patients will need more than one procedure to achieve success.
Authors: A Natale; E Pisanó; S Beheiry; M Richey; F Leonelli; R Fanelli; M Potenza; G Tomassoni Journal: Am J Cardiol Date: 2000-06-01 Impact factor: 2.778
Authors: V Fuster; L E Rydén; R W Asinger; D S Cannom; H J Crijns; R L Frye; J L Halperin; G N Kay; W W Klein; S Lévy; R L McNamara; E N Prystowsky; L S Wann; D G Wyse; R J Gibbons; E M Antman; J S Alpert; D P Faxon; V Fuster; G Gregoratos; L F Hiratzka; A K Jacobs; R O Russell; S C Smith; W W Klein; A Alonso-Garcia; C Blomström-Lundqvist; G de Backer; M Flather; J Hradec; A Oto; A Parkhomenko; S Silber; A Torbicki Journal: Circulation Date: 2001-10-23 Impact factor: 29.690
Authors: Samuel Lévy; A John Camm; Sanjeev Saksena; Etienne Aliot; Gunter Breithardt; Harry J G M Crijns; D Wyn Davies; G Neal Kay; Eric N Prystowsky; Richard Sutton; Albert L Waldo; D George Wyse Journal: J Cardiovasc Electrophysiol Date: 2003-04
Authors: J L Cox; N Ad; T Palazzo; S Fitzpatrick; J P Suyderhoud; K W DeGroot; E A Pirovic; H C Lou; W Z Duvall; Y D Kim Journal: Semin Thorac Cardiovasc Surg Date: 2000-01
Authors: M Haïssaguerre; P Jaïs; D C Shah; S Garrigue; A Takahashi; T Lavergne; M Hocini; J T Peng; R Roudaut; J Clémenty Journal: Circulation Date: 2000-03-28 Impact factor: 29.690
Authors: S Ernst; M Schlüter; F Ouyang; A Khanedani; R Cappato; J Hebe; M Volkmer; M Antz; K H Kuck Journal: Circulation Date: 1999-11-16 Impact factor: 29.690
Authors: M Haïssaguerre; P Jaïs; D C Shah; T Arentz; D Kalusche; A Takahashi; S Garrigue; M Hocini; J T Peng; J Clémenty Journal: J Cardiovasc Electrophysiol Date: 2000-01
Authors: Thomas Deneke; Anja Schade; Joachim Krug; Karsten Stahl; Geza Atilla Szollosi; Dong In Shin; Clemens Nino Schukro; Mohamed El Tarahony; Enrique Murillo; Semko Aram; Gabriele Robhirt; Thomas Lawo; Andreas Mugge; Peter H Grewe; Sebastian Kerber Journal: J Atr Fibrillation Date: 2012-02-02
Authors: Dhiraj Gupta; Mark J Earley; Guy A Haywood; Laura Richmond; Melissa Fitzgerald; Pipin Kojodjojo; Simon C Sporton; Nicholas S Peters; Paul Broadhurst; Richard J Schilling Journal: Heart Date: 2006-11-29 Impact factor: 5.994
Authors: John D Ferguson; Adam Helms; J Michael Mangrum; Srijoy Mahapatra; Pamela Mason; Ken Bilchick; George McDaniel; David Wiggins; John P DiMarco Journal: Circ Arrhythm Electrophysiol Date: 2009-12