BACKGROUND: Successful mitral isthmus (MI) ablation may reduce recurrence of atrial fibrillation (AF) and macro-reentrant atrial tachycardia (AT) after pulmonary vein isolation (PVI) for AF. OBJECTIVE: To determine if achieving bidirectional MI conduction block (MIB) during circumferential pulmonary vein ablation (CPVA) plus left atrial linear ablation (LALA) affects development of AT. METHODS: Sixty consecutive patients with persistent (n = 25) or paroxysmal (n = 35) AF undergoing CPVA plus LALA at the MI and LA roof were evaluated in a prospective, nonrandomized study. RESULTS: PVI was achieved in all patients. Bidirectional MI block was achieved in 50 of 60 patients (83%). During 18 +/- 5 months follow-up, 12 patients (20%) developed recurrent AF and 15 (25%) developed AT. Patients in whom MIB was not achieved at initial ablation had four times higher risk of developing AT (P = 0.008, 95% confidence interval 1.43-11.48) versus patients with MIB. In 12 patients with AT undergoing repeat ablation, 22 ATs were identified, with reentry involving the MI in nine, the LA roof in six, and the ridge between the LA appendage and left PVs in seven. In patients with MIB at initial ablation, recovery of MI conduction was seen in eight of 13 undergoing repeat ablation. CONCLUSIONS: AT occurring after CPVA plus LALA is often due to incomplete MI ablation, but may also occur at the LA roof, and ridge between the LA appendage and left PVs. Failure to achieve MI block increases the risk of developing AT. Resumption of MI conduction may also be a mechanism for AT recurrence. (PACE 2010; 460-468).
BACKGROUND: Successful mitral isthmus (MI) ablation may reduce recurrence of atrial fibrillation (AF) and macro-reentrant atrial tachycardia (AT) after pulmonary vein isolation (PVI) for AF. OBJECTIVE: To determine if achieving bidirectional MI conduction block (MIB) during circumferential pulmonary vein ablation (CPVA) plus left atrial linear ablation (LALA) affects development of AT. METHODS: Sixty consecutive patients with persistent (n = 25) or paroxysmal (n = 35) AF undergoing CPVA plus LALA at the MI and LA roof were evaluated in a prospective, nonrandomized study. RESULTS: PVI was achieved in all patients. Bidirectional MI block was achieved in 50 of 60 patients (83%). During 18 +/- 5 months follow-up, 12 patients (20%) developed recurrent AF and 15 (25%) developed AT. Patients in whom MIB was not achieved at initial ablation had four times higher risk of developing AT (P = 0.008, 95% confidence interval 1.43-11.48) versus patients with MIB. In 12 patients with AT undergoing repeat ablation, 22 ATs were identified, with reentry involving the MI in nine, the LA roof in six, and the ridge between the LA appendage and left PVs in seven. In patients with MIB at initial ablation, recovery of MI conduction was seen in eight of 13 undergoing repeat ablation. CONCLUSIONS: AT occurring after CPVA plus LALA is often due to incomplete MI ablation, but may also occur at the LA roof, and ridge between the LA appendage and left PVs. Failure to achieve MI block increases the risk of developing AT. Resumption of MI conduction may also be a mechanism for AT recurrence. (PACE 2010; 460-468).
Authors: José L Báez-Escudero; Percy Francisco Morales; Amish S Dave; Christine M Sasaridis; Young-Hoon Kim; Kaoru Okishige; Miguel Valderrábano Journal: Heart Rhythm Date: 2012-03-07 Impact factor: 6.343
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; Jose Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: J Interv Card Electrophysiol Date: 2012-03 Impact factor: 1.900
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Europace Date: 2018-01-01 Impact factor: 5.214