open access

Vol 64, No 1 (2006)
Other
Published online: 2006-01-23
Submitted: 2012-12-28
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ORIGINAL ARTICLE
Selective ablation or isolation of all pulmonary veins in atrial fibrillation – when and for whom?

Franciszek Walczak, Łukasz Szumowski, Piotr Urbanek, Ewa Szufladowicz, Paweł Derejko, Piotr Kułakowski, Rafał Baranowski, Robert Bodalski, Roman Kępski, Magdalena Zagrodzka, Karina Onish, Iwona Bestry, Marek Konka, Beata Kuśmierczyk, Agnieszka Maryniak
Kardiol Pol 2006;64(1):26-35.

open access

Vol 64, No 1 (2006)
Other
Published online: 2006-01-23
Submitted: 2012-12-28

Abstract

Introduction: Targeted treatment of atrial fibrillation (AF) involves circumferential isolation of all pulmonary veins (PV) or isolation of electrical connections within their ostia. Only in some cases are the real localisation and number of triggering foci, the anatomy of venous ostia as well as the form of AF (paroxysmal, persistent, chronic, primary or secondary) taken into consideration. Aim: To compare the results of selective electrical isolation (1-3 PV ostia or ablation of a single focus in other veins or atrium) versus isolation of all pulmonary veins. Methods: RF ablation was performed in eighty patients (51 men, 29 women) with symptomatic, drug-refractory AF. Fifty-nine patients had paroxysmal AF (PAF), 16 persistent (AFpers), and 5 chronic AF (AFchro). Selective ablation was carried out in those patients who had detectable AF triggers during sinus rhythm – supraventricular extrasystolic beats (SVEB) of 1 to 3 morphologies (group I). Extended ablation – isolation of all 4-5 PV – was performed in patients with multiple SVEB morphologies and heterogeneous electrical connections within all PV (group II). Group I consisted of 60 patients (22 females) aged 46±14 years, whereas group II comprised 20 patients (7 females) aged 52±13 years. In 24 patients (18 from group I and 6 from group II) with concomitant typical atrial flutter, an ablation line in the cavo-tricuspid isthmus was also performed. Long-term results were assessed 17±15.6 (4-105) months after the procedure based on routine ECG, ambulatory 24-hour ECG monitoring, clinical evaluation and regular phone calls. In patients with PAF, left atrial diameter

Abstract

Introduction: Targeted treatment of atrial fibrillation (AF) involves circumferential isolation of all pulmonary veins (PV) or isolation of electrical connections within their ostia. Only in some cases are the real localisation and number of triggering foci, the anatomy of venous ostia as well as the form of AF (paroxysmal, persistent, chronic, primary or secondary) taken into consideration. Aim: To compare the results of selective electrical isolation (1-3 PV ostia or ablation of a single focus in other veins or atrium) versus isolation of all pulmonary veins. Methods: RF ablation was performed in eighty patients (51 men, 29 women) with symptomatic, drug-refractory AF. Fifty-nine patients had paroxysmal AF (PAF), 16 persistent (AFpers), and 5 chronic AF (AFchro). Selective ablation was carried out in those patients who had detectable AF triggers during sinus rhythm – supraventricular extrasystolic beats (SVEB) of 1 to 3 morphologies (group I). Extended ablation – isolation of all 4-5 PV – was performed in patients with multiple SVEB morphologies and heterogeneous electrical connections within all PV (group II). Group I consisted of 60 patients (22 females) aged 46±14 years, whereas group II comprised 20 patients (7 females) aged 52±13 years. In 24 patients (18 from group I and 6 from group II) with concomitant typical atrial flutter, an ablation line in the cavo-tricuspid isthmus was also performed. Long-term results were assessed 17±15.6 (4-105) months after the procedure based on routine ECG, ambulatory 24-hour ECG monitoring, clinical evaluation and regular phone calls. In patients with PAF, left atrial diameter
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Keywords

atrial fibrillation; ablation

About this article
Title

ORIGINAL ARTICLE
Selective ablation or isolation of all pulmonary veins in atrial fibrillation – when and for whom?

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 1 (2006)

Pages

26-35

Published online

2006-01-23

Bibliographic record

Kardiol Pol 2006;64(1):26-35.

Keywords

atrial fibrillation
ablation

Authors

Franciszek Walczak
Łukasz Szumowski
Piotr Urbanek
Ewa Szufladowicz
Paweł Derejko
Piotr Kułakowski
Rafał Baranowski
Robert Bodalski
Roman Kępski
Magdalena Zagrodzka
Karina Onish
Iwona Bestry
Marek Konka
Beata Kuśmierczyk
Agnieszka Maryniak

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