Hwan-Cheol Park1, DaeIn Lee2, Jaemin Shim2, Jong-Il Choi2, Young-Hoon Kim2. 1. Department of Internal Medicine, College of Medicine, Hanyang University Guri Hospital, Guri City, Republic of Korea. pigpooh76@hanmail.net. 2. Arrhyhmia Center, College of Medicine, Korea University Medical Center, Seoul, Republic of Korea.
Abstract
BACKGROUND: The left atrial appendage (LAA) can be a source of atrial fibrillation (AF) triggering or a part of reentry. We sought to determine the characteristics and clinical outcomes of patients with LAA potential delay including electrical isolation (LAAEI) following LA anterior wall (LAAW) ablation for AF. METHODS: LAAW ablation cases were collected from among 846 patients who underwent catheter ablation (CA). A total of 89 patients were enrolled; they were divided into three groups according to the extent of LAA potential injury. The ejection fractions (EFs) of the LAA and LA were measured by means of LA angiograms. RESULTS: The mean age of all patients was 56.2 ± 10.7 years (74 males, 83 %). In 47 of the 89 patients, an LAA potential delay was identified after LAAW ablation (group 2). LAAEI was seen in 18 patients (group 3). In the remaining 24 patients, there was no LAA potential delay or LAAEI (group 1). The mean EF decreased significantly after CA in group 3 (P < 0.001). At 21-month follow-up, three patients (17 %) in group 3 had recurrence compared with 11 (42 %) in group 2 and 12 (46 %) in group 3 (P = 0.028). In multivariate analysis, diabetes mellitus and LAA potential delay were independent predictors of AF recurrence (P = 0.021, P = 0.008, respectively). CONCLUSION: Ablation of the LA anterior wall near the insertion of Bachmann's bundle and the neck of the LAA resulting in LAA potential delay or electrical isolation is effective in preventing recurrence of atrial fibrillation.
BACKGROUND: The left atrial appendage (LAA) can be a source of atrial fibrillation (AF) triggering or a part of reentry. We sought to determine the characteristics and clinical outcomes of patients with LAA potential delay including electrical isolation (LAAEI) following LA anterior wall (LAAW) ablation for AF. METHODS: LAAW ablation cases were collected from among 846 patients who underwent catheter ablation (CA). A total of 89 patients were enrolled; they were divided into three groups according to the extent of LAA potential injury. The ejection fractions (EFs) of the LAA and LA were measured by means of LA angiograms. RESULTS: The mean age of all patients was 56.2 ± 10.7 years (74 males, 83 %). In 47 of the 89 patients, an LAA potential delay was identified after LAAW ablation (group 2). LAAEI was seen in 18 patients (group 3). In the remaining 24 patients, there was no LAA potential delay or LAAEI (group 1). The mean EF decreased significantly after CA in group 3 (P < 0.001). At 21-month follow-up, three patients (17 %) in group 3 had recurrence compared with 11 (42 %) in group 2 and 12 (46 %) in group 3 (P = 0.028). In multivariate analysis, diabetes mellitus and LAA potential delay were independent predictors of AF recurrence (P = 0.021, P = 0.008, respectively). CONCLUSION: Ablation of the LA anterior wall near the insertion of Bachmann's bundle and the neck of the LAA resulting in LAA potential delay or electrical isolation is effective in preventing recurrence of atrial fibrillation.
Entities:
Keywords:
Bachmann’s bundle; Catheter ablation (CA); Left atrial appendage (LAA)
Authors: Roberto M Lang; Michelle Bierig; Richard B Devereux; Frank A Flachskampf; Elyse Foster; Patricia A Pellikka; Michael H Picard; Mary J Roman; James Seward; Jack S Shanewise; Scott D Solomon; Kirk T Spencer; Martin St John Sutton; William J Stewart Journal: J Am Soc Echocardiogr Date: 2005-12 Impact factor: 5.251
Authors: Hugh Calkins; Josep Brugada; Douglas L Packer; Riccardo Cappato; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; David E Haines; Michel Haissaguerre; Yoshito Iesaka; Warren Jackman; Pierre Jais; Hans Kottkamp; Karl Heinz Kuck; Bruce D Lindsay; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Andrea Natale; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Jeremy N Ruskin; Richard J Shemin Journal: Heart Rhythm Date: 2007-04-30 Impact factor: 6.343
Authors: Luigi Di Biase; J David Burkhardt; Prasant Mohanty; Javier Sanchez; Sanghamitra Mohanty; Rodney Horton; G Joseph Gallinghouse; Shane M Bailey; Jason D Zagrodzky; Pasquale Santangeli; Steven Hao; Richard Hongo; Salwa Beheiry; Sakis Themistoclakis; Aldo Bonso; Antonio Rossillo; Andrea Corrado; Antonio Raviele; Amin Al-Ahmad; Paul Wang; Jennifer E Cummings; Robert A Schweikert; Gemma Pelargonio; Antonio Dello Russo; Michela Casella; Pietro Santarelli; William R Lewis; Andrea Natale Journal: Circulation Date: 2010-07-06 Impact factor: 29.690
Authors: Giuseppe De Martino; Giuseppe Nasso; Alessio Gasperetti; Marco Moscarelli; Carmine Mancusi; Giuseppe Della Ratta; Claudia Calvanese; Gianfranco Mitacchione; Raffaele Bonifazi; Nicola Di Bari; Enrico Vassallo; Marco Schiavone; Mario Gaudino; Giovanni B Forleo; Giuseppe Speziale Journal: J Interv Card Electrophysiol Date: 2021-03-08 Impact factor: 1.759