Nebojša Mujović1,2, Milan Marinković1, Nebojša Marković1, Goran Stanković1,2, Gregory Y H Lip2,3, Carina Blomstrom-Lundqvist4, T Jared Bunch5,6, Tatjana S Potpara1,2. 1. Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia. 2. School of Medicine, University of Belgrade, Belgrade, Serbia. 3. Institute of Cardiovascular Science, University of Birmingham, Edgbaston, Birmingham, UK. 4. Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden. 5. Intermountain Medical Center Heart Institute, Intermountain Medical Center, Murray, UT, USA. 6. Department of Internal Medicine, Stanford University, Palo Alto, CA, USA.
Abstract
BACKGROUND: Data on the roof line (RL) and mitral isthmus line (MIL) reconnections after atrial fibrillation (AF) catheter ablation (CA) are scarce. OBJECTIVE: We studied the RL and MIL completeness and localization of reconnection sites in consecutive patients after their first-ever AF-CA. METHODS: We prospectively included 41 consecutive AF patients who underwent predefined lesion sets of two circumferential lines (CLs) for ipsilateral pulmonary vein isolation (PVI) combined with a RL and lateral MIL. Three months after CA, all patients underwent invasive follow-up procedure for line persistency evaluation, irrespective of clinical outcome. RESULTS: At the time of index ablation, PVI-CLs, RL, and MIL was completed in 41 (100%), 39 (95%), and 34 (83%) of patients, respectively. At the 3-month follow-up procedure, reconnections of PVI-CLs, RL, and MIL were found in 61% (25/41), 28% (11/39), and 24% (8/34) of patients, respectively. The 3-month reconnections were located commonly in the anterior and posterior PVI-CL segments, and rarely in the right third of RL and in the posterior part of MIL. The 3-month reconnections were rarely seen at the sites of acute reconnections during index procedure (6%, 20%, and 25% of the PVI-CL segments, RL segments, and MIL segments, respectively). CONCLUSIONS: To our knowledge, this is the first study systematically investigating the reconnection of standardized left atrium linear lesions such as RL and MIL after RF-CA for AF in consecutive patients. The RL and MIL 3-month reconnection rates were relatively low (28% and 24%), with poor anatomical concordance between the sites with acute and 3-month reconnections.
BACKGROUND: Data on the roof line (RL) and mitral isthmus line (MIL) reconnections after atrial fibrillation (AF) catheter ablation (CA) are scarce. OBJECTIVE: We studied the RL and MIL completeness and localization of reconnection sites in consecutive patients after their first-ever AF-CA. METHODS: We prospectively included 41 consecutive AFpatients who underwent predefined lesion sets of two circumferential lines (CLs) for ipsilateral pulmonary vein isolation (PVI) combined with a RL and lateral MIL. Three months after CA, all patients underwent invasive follow-up procedure for line persistency evaluation, irrespective of clinical outcome. RESULTS: At the time of index ablation, PVI-CLs, RL, and MIL was completed in 41 (100%), 39 (95%), and 34 (83%) of patients, respectively. At the 3-month follow-up procedure, reconnections of PVI-CLs, RL, and MIL were found in 61% (25/41), 28% (11/39), and 24% (8/34) of patients, respectively. The 3-month reconnections were located commonly in the anterior and posterior PVI-CL segments, and rarely in the right third of RL and in the posterior part of MIL. The 3-month reconnections were rarely seen at the sites of acute reconnections during index procedure (6%, 20%, and 25% of the PVI-CL segments, RL segments, and MIL segments, respectively). CONCLUSIONS: To our knowledge, this is the first study systematically investigating the reconnection of standardized left atrium linear lesions such as RL and MIL after RF-CA for AF in consecutive patients. The RL and MIL 3-month reconnection rates were relatively low (28% and 24%), with poor anatomical concordance between the sites with acute and 3-month reconnections.
Authors: Roya Kamali; Jordan Kump; Elyar Ghafoori; Matthias Lange; Nan Hu; T Jared Bunch; Derek J Dosdall; Rob S Macleod; Ravi Ranjan Journal: JACC Clin Electrophysiol Date: 2021-02-24
Authors: Nebojša Mujović; Milan Marinković; Nebojša Marković; Vera Vučićević; Gregory Y H Lip; T Jared Bunch; Tatjana S Potpara Journal: Sci Rep Date: 2018-06-29 Impact factor: 4.379
Authors: Nebojša M Mujović; Milan M Marinković; Ivana Nedeljković; Nebojša Marković; Marko Banović; Vera Vučićević; Goran Stanković; Tatjana S Potpara Journal: J Am Heart Assoc Date: 2021-01-28 Impact factor: 5.501