AIMS: This study evaluates whether non-inducibility of atrial fibrillation (AF) after achieving bi-directional electrical pulmonary vein (PV) isolation is a useful predictor of freedom from AF recurrence. METHODS AND RESULTS: This study included 102 consecutive patients who underwent PV isolation for symptomatic paroxysmal (59%), persistent (32%), or permanent (9%) AF. Patients were followed for 16+/-10 months. Complete isolation of all four PVs was confirmed by demonstration of bi-directional block, defined by both loss of PV potentials and failure to capture the LA by pacing (at 10 mA) 10-14 bipolar pairs of electrodes on a circumferential catheter positioned at the entrance of the PV. Induction of AF by burst pacing on/off isoproterenol was attempted after PV isolation. Freedom from recurrent symptomatic or asymptomatic AF was present in 70% of patients at 6 months and 62% of patients at 12 months. In multi-variable analysis, non-inducibility post-PV isolation (OR=3.84, P=0.047) and paroxysmal AF (OR=4.80, P=0.012) predicted freedom from AF at 12 months. CONCLUSION: Non-inducibility of AF after bi-directional PV isolation predicts maintenance of sinus rhythm. This finding suggests that routine extensive left atrial ablation may be unnecessary.
AIMS: This study evaluates whether non-inducibility of atrial fibrillation (AF) after achieving bi-directional electrical pulmonary vein (PV) isolation is a useful predictor of freedom from AF recurrence. METHODS AND RESULTS: This study included 102 consecutive patients who underwent PV isolation for symptomatic paroxysmal (59%), persistent (32%), or permanent (9%) AF. Patients were followed for 16+/-10 months. Complete isolation of all four PVs was confirmed by demonstration of bi-directional block, defined by both loss of PV potentials and failure to capture the LA by pacing (at 10 mA) 10-14 bipolar pairs of electrodes on a circumferential catheter positioned at the entrance of the PV. Induction of AF by burst pacing on/off isoproterenol was attempted after PV isolation. Freedom from recurrent symptomatic or asymptomatic AF was present in 70% of patients at 6 months and 62% of patients at 12 months. In multi-variable analysis, non-inducibility post-PV isolation (OR=3.84, P=0.047) and paroxysmal AF (OR=4.80, P=0.012) predicted freedom from AF at 12 months. CONCLUSION: Non-inducibility of AF after bi-directional PV isolation predicts maintenance of sinus rhythm. This finding suggests that routine extensive left atrial ablation may be unnecessary.
Authors: S A Chen; M H Hsieh; C T Tai; C F Tsai; V S Prakash; W C Yu; T L Hsu; Y A Ding; M S Chang Journal: Circulation Date: 1999-11-02 Impact factor: 29.690
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: Edward P Gerstenfeld; Sanjay Dixit; David Callans; Robert Rho; Yadavendra Rajawat; Erica Zado; Francis E Marchlinski Journal: J Cardiovasc Electrophysiol Date: 2002-10
Authors: M Haïssaguerre; D C Shah; P Jaïs; M Hocini; T Yamane; I Deisenhofer; M Chauvin; S Garrigue; J Clémenty Journal: Circulation Date: 2000-11-14 Impact factor: 29.690
Authors: C Pappone; S Rosanio; G Oreto; M Tocchi; F Gugliotta; G Vicedomini; A Salvati; C Dicandia; P Mazzone; V Santinelli; S Gulletta; S Chierchia Journal: Circulation Date: 2000-11-21 Impact factor: 29.690
Authors: Hakan Oral; Bradley P Knight; Hiroshi Tada; Mehmet Ozaydin; Aman Chugh; Sohail Hassan; Christoph Scharf; Steve W K Lai; Radmira Greenstein; Frank Pelosi; S Adam Strickberger; Fred Morady Journal: Circulation Date: 2002-03-05 Impact factor: 29.690
Authors: Hakan Oral; Mehmet Ozaydin; Hiroshi Tada; Aman Chugh; Christoph Scharf; Sohail Hassan; Steve Lai; Radmira Greenstein; Frank Pelosi; Bradley P Knight; S Adam Strickberger; Fred Morady Journal: J Cardiovasc Electrophysiol Date: 2002-07
Authors: Francis E Marchlinski; David Callans; Sanjay Dixit; Edward P Gerstenfeld; Robert Rho; Jian-Fang Ren; Erica Zado Journal: J Cardiovasc Electrophysiol Date: 2003-04
Authors: Thomas H Hauser; Dana C Peters; Matteo V Wylie; Catherine Lau; Mark E Josephson; Warren J Manning Journal: J Atr Fibrillation Date: 2013-04-06
Authors: Vidal Essebag; John V Wylie; Matthew R Reynolds; Ferdinando Baldessin; Seth McClennen; Alexei Shvilkin; Joseph Germano; Allison Richardson; Peter J Zimetbaum; Mark E Josephson Journal: J Interv Card Electrophysiol Date: 2007-01-18 Impact factor: 1.900
Authors: Dana C Peters; John V Wylie; Thomas H Hauser; Reza Nezafat; Yuchi Han; Jeong Joo Woo; Jason Taclas; Kraig V Kissinger; Beth Goddu; Mark E Josephson; Warren J Manning Journal: JACC Cardiovasc Imaging Date: 2009-03