open access

Vol 63, No 10 (2005)
Other
Published online: 2005-10-21
Submitted: 2012-12-28
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ORIGINAL ARTICLE
Circumferential pulmonary vein RF ablation in the treatment of atrial fibrillation: 3-year experience of one centre

Anna-Maria Wnuk-Wojnar, Maria Trusz-Gluza, Cezary Czerwiński, Iwona Woźniak-Skowerska, Krzysztof Szydło, Andrzej Hoffmann, Seweryn Nowak, Krystian Wita, Ewa Konarska-Kuszewska, Jolanta Krauze, Anna Rybicka-Musialik, Agnieszka Drzewiecka-Gerber
Kardiol Pol 2005;63(10):362-370.

open access

Vol 63, No 10 (2005)
Other
Published online: 2005-10-21
Submitted: 2012-12-28

Abstract

Introduction: In patients with atrial fibrillation (AF), significantly symptomatic in particular, restoring and maintaining sinus rhythm is one of treatment strategias. Considering the limited efficacy and side effects of anti-arrhythmic agents, growing hopes are attributed to the developing techniques of percutaneous ablation. Aim: To determine the efficacy and safety of circumferential pulmonary vein ablation performed using the CARTO system in patients with paroxysmal or permanent AF. Methods: The study involved 94 patients (mean age 54 years, males 65%, structural heart disease 29.4%) with symptomatic, recurrent and AF resistant to antiarrhythmic agents (paroxysmal AF 63.8%), selected for circumferential pulmonary vein ablation with the Pappone method. Follow-up examinations were performed after 1, 3, 6, 9, and 12 months. The symptoms, ECG, 24-hour ECG monitoring and complications were recorded. Results: Mean procedure and fluoroscopy durations were 4.5 hours and 22.4 minutes respectively. The long-term follow-up ranged from 3 to 24 months, with median time of 12 months. At six months, 47.8% of patients remained free from AF, and improvement in terms of infrequent arrhythmia occurrence and low incidence of symptoms in an additional 36.7% was observed. Efficacy was lower in patients with permanent AF (12 months 90% vs 70%). Complications were seen in six (6.4%) patients: cardiac tamponade in two patients; and pericardial effusion, retroperitoneal bleeding, stroke, and pulmonary vein thrombosis each in one patient. Conclusions: Circumferential pulmonary vein ablation leads to resolution of arrhythmia or marked clinical improvement in about 75% of patients with symptomatic, resistant AF. The success rate is lower in patients with permanent rather than paroxysmal AF. As severe complications are not unlikely, the indications for such therapy must be carefully balanced.

Abstract

Introduction: In patients with atrial fibrillation (AF), significantly symptomatic in particular, restoring and maintaining sinus rhythm is one of treatment strategias. Considering the limited efficacy and side effects of anti-arrhythmic agents, growing hopes are attributed to the developing techniques of percutaneous ablation. Aim: To determine the efficacy and safety of circumferential pulmonary vein ablation performed using the CARTO system in patients with paroxysmal or permanent AF. Methods: The study involved 94 patients (mean age 54 years, males 65%, structural heart disease 29.4%) with symptomatic, recurrent and AF resistant to antiarrhythmic agents (paroxysmal AF 63.8%), selected for circumferential pulmonary vein ablation with the Pappone method. Follow-up examinations were performed after 1, 3, 6, 9, and 12 months. The symptoms, ECG, 24-hour ECG monitoring and complications were recorded. Results: Mean procedure and fluoroscopy durations were 4.5 hours and 22.4 minutes respectively. The long-term follow-up ranged from 3 to 24 months, with median time of 12 months. At six months, 47.8% of patients remained free from AF, and improvement in terms of infrequent arrhythmia occurrence and low incidence of symptoms in an additional 36.7% was observed. Efficacy was lower in patients with permanent AF (12 months 90% vs 70%). Complications were seen in six (6.4%) patients: cardiac tamponade in two patients; and pericardial effusion, retroperitoneal bleeding, stroke, and pulmonary vein thrombosis each in one patient. Conclusions: Circumferential pulmonary vein ablation leads to resolution of arrhythmia or marked clinical improvement in about 75% of patients with symptomatic, resistant AF. The success rate is lower in patients with permanent rather than paroxysmal AF. As severe complications are not unlikely, the indications for such therapy must be carefully balanced.
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Keywords

atrial fibrillation; ablation; pulmonary veins

About this article
Title

ORIGINAL ARTICLE
Circumferential pulmonary vein RF ablation in the treatment of atrial fibrillation: 3-year experience of one centre

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 63, No 10 (2005)

Pages

362-370

Published online

2005-10-21

Bibliographic record

Kardiol Pol 2005;63(10):362-370.

Keywords

atrial fibrillation
ablation
pulmonary veins

Authors

Anna-Maria Wnuk-Wojnar
Maria Trusz-Gluza
Cezary Czerwiński
Iwona Woźniak-Skowerska
Krzysztof Szydło
Andrzej Hoffmann
Seweryn Nowak
Krystian Wita
Ewa Konarska-Kuszewska
Jolanta Krauze
Anna Rybicka-Musialik
Agnieszka Drzewiecka-Gerber

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