OBJECTIVE: Some have suggested the superiority of biatrial versus left atrial lesions. We sought to analyze our experience. METHODS: We retrospectively reviewed 305 consecutive patients from 2007 to 2011. Rhythm success was defined as freedom from atrial fibrillation (AF) or flutter determined by 12-lead electrocardiograms at 3-month intervals. Lesions sets were pulmonary vein isolation (PVI), left-extended (PVI + mitral valve annulus [MV] lesion ± left atrial appendage lesion [LAA]) or biatrial-extended (right atrial ablation + PVI + MV ± LAA). RESULTS: The success rates of PVI, left-extended, and biatrial-extended lesions were as follows: at 3 months, 56.7%, 74.7%, and 79.4% (P = .003); at 6 months, 56.9%, 72.9%, and 74.6% (P = .02); at 9 months, 54.6%, 72.5%, and 83.3% (P < .001); and at 12 months, 52.6%, 76.1%, and 80.0% (P < .001). Biatrial lesions had a higher rate of pacemaker placement than did left atrial lesions (16.5% vs 7.5%; P = .02). When we grouped patients by left lesion (PVI, PVI + MV, PVI + MV + LAA) irrespective of right atrial ablation, success was as follows: 3 months, 57.9%, 71.1%, and 87.8% (P < .01); 6 months, 58.1%, 71.6%, and 77.6% (P = .03); 9 months, 55.9%, 71.3%, and 89.6% (P < .01); and 12 months, 54.1%, 74.7%, and 83.7% (P < .01). CONCLUSIONS: PVI is associated with lower rhythm success than an extended left atrial lesion set. The addition of a right atrial lesion to an extended left atrial lesion set does not improve efficacy, but it does increase the rate of pacemaker placement for sinus dysfunction. Adding an LAA lesion may confer additional efficacy when added to a lesion set that includes PVI + MV.
OBJECTIVE: Some have suggested the superiority of biatrial versus left atrial lesions. We sought to analyze our experience. METHODS: We retrospectively reviewed 305 consecutive patients from 2007 to 2011. Rhythm success was defined as freedom from atrial fibrillation (AF) or flutter determined by 12-lead electrocardiograms at 3-month intervals. Lesions sets were pulmonary vein isolation (PVI), left-extended (PVI + mitral valve annulus [MV] lesion ± left atrial appendage lesion [LAA]) or biatrial-extended (right atrial ablation + PVI + MV ± LAA). RESULTS: The success rates of PVI, left-extended, and biatrial-extended lesions were as follows: at 3 months, 56.7%, 74.7%, and 79.4% (P = .003); at 6 months, 56.9%, 72.9%, and 74.6% (P = .02); at 9 months, 54.6%, 72.5%, and 83.3% (P < .001); and at 12 months, 52.6%, 76.1%, and 80.0% (P < .001). Biatrial lesions had a higher rate of pacemaker placement than did left atrial lesions (16.5% vs 7.5%; P = .02). When we grouped patients by left lesion (PVI, PVI + MV, PVI + MV + LAA) irrespective of right atrial ablation, success was as follows: 3 months, 57.9%, 71.1%, and 87.8% (P < .01); 6 months, 58.1%, 71.6%, and 77.6% (P = .03); 9 months, 55.9%, 71.3%, and 89.6% (P < .01); and 12 months, 54.1%, 74.7%, and 83.7% (P < .01). CONCLUSIONS: PVI is associated with lower rhythm success than an extended left atrial lesion set. The addition of a right atrial lesion to an extended left atrial lesion set does not improve efficacy, but it does increase the rate of pacemaker placement for sinus dysfunction. Adding an LAA lesion may confer additional efficacy when added to a lesion set that includes PVI + MV.
Authors: Karin S Coyne; Clark Paramore; Susan Grandy; Marco Mercader; Matthew Reynolds; Peter Zimetbaum Journal: Value Health Date: 2006 Sep-Oct Impact factor: 5.725
Authors: A Marc Gillinov; Sekar Bhavani; Eugene H Blackstone; Jeevanantham Rajeswaran; Lars G Svensson; Jose L Navia; B Gösta Pettersson; Joseph F Sabik; Nicholas G Smedira; Tomislav Mihaljevic; Patrick M McCarthy; Jeanne Shewchik; Andrea Natale Journal: Ann Thorac Surg Date: 2006-08 Impact factor: 4.330
Authors: Thomas Deneke; Krishna Khargi; Peter Hubert Grewe; Stefan von Dryander; Frank Kuschkowitz; Thomas Lawo; Klaus-Michael Müller; Axel Laczkovics; Bernd Lemke Journal: J Am Coll Cardiol Date: 2002-05-15 Impact factor: 24.094
Authors: Timo Weimar; Stefano Schena; Marci S Bailey; Hersh S Maniar; Richard B Schuessler; James L Cox; Ralph J Damiano Journal: Circ Arrhythm Electrophysiol Date: 2011-11-17
Authors: James S Gammie; Michel Haddad; Sarah Milford-Beland; Karl F Welke; T Bruce Ferguson; Sean M O'Brien; Bartley P Griffith; Eric D Peterson Journal: Ann Thorac Surg Date: 2008-03 Impact factor: 4.330
Authors: Sydney L Gaynor; Michael D Diodato; Sunil M Prasad; Yosuke Ishii; Richard B Schuessler; Marci S Bailey; Nicholas R Damiano; Jeffrey B Bloch; Marc R Moon; Ralph J Damiano Journal: J Thorac Cardiovasc Surg Date: 2004-10 Impact factor: 5.209
Authors: A Marc Gillinov; Annetine C Gelijns; Michael K Parides; Joseph J DeRose; Alan J Moskowitz; Pierre Voisine; Gorav Ailawadi; Denis Bouchard; Peter K Smith; Michael J Mack; Michael A Acker; John C Mullen; Eric A Rose; Helena L Chang; John D Puskas; Jean-Philippe Couderc; Timothy J Gardner; Robin Varghese; Keith A Horvath; Steven F Bolling; Robert E Michler; Nancy L Geller; Deborah D Ascheim; Marissa A Miller; Emilia Bagiella; Ellen G Moquete; Paula Williams; Wendy C Taddei-Peters; Patrick T O'Gara; Eugene H Blackstone; Michael Argenziano Journal: N Engl J Med Date: 2015-03-16 Impact factor: 91.245
Authors: Joseph J DeRose; Donna M Mancini; Helena L Chang; Michael Argenziano; François Dagenais; Gorav Ailawadi; Louis P Perrault; Michael K Parides; Wendy C Taddei-Peters; Michael J Mack; Donald D Glower; Babatunde A Yerokun; Pavan Atluri; John C Mullen; John D Puskas; Karen O'Sullivan; Nancy M Sledz; Hugo Tremblay; Ellen Moquete; Bart S Ferket; Alan J Moskowitz; Alexander Iribarne; Annetine C Gelijns; Patrick T O'Gara; Eugene H Blackstone; A Marc Gillinov Journal: J Am Coll Cardiol Date: 2019-05-21 Impact factor: 24.094