Open AccessEfficacy and Safety of Catheter Ablation for Persistent or Permanent Atrial Fibrillation
Author(s) -
Muraoka Soichi,
Mitsutake Chiharu,
Takashima Hideo,
Nakashima Hideko,
Yasuda Tomoo,
Matsumoto Naomichi,
Kumagai Koichiro,
Saku Keijiro
Publication year - 2007
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/s1880-4276(07)80004-4
Subject(s) - medicine , atrial fibrillation , atrial tachycardia , sinus rhythm , cardiology , ablation , atrial flutter , catheter ablation , pulmonary vein , stenosis , surgery
Introduction: Radiofrequency catheter ablation (RFCA) that targets pulmonary veins (PV) is an established treatment for paroxysmal atrial fibrillation (PAF). Recent studies have demonstrated that RFCA can eliminate PAF in over 90% of patients. However, the effectiveness for persistent or permanent AF has not been clarified. Methods and Results: 27 patients (29%) had persistent or permanent AF. RFCA including PV antrum isolation (PVAI) was performed using a circular mapping catheter in the patients with persistent or permanent AF. Four patients (15%) underwent only PVAI. Thirteen patients (48%) underwent PVAI and left atrium roof and/or mitral isthmus linear ablation. Ten patients (37%) underwent PVAI and RFCA to an area with complex fractionated atrial electrograms. All patients were observed for over a year. After repeat ablation at mean followup of 16 ± 5 months, 23 patients (85%) had normal sinus rhythm and were free of symptomatic AF or atrial flutter. Three patients required antiarrhythmic drugs to maintain sinus rhythm during follow‐up period. One patient had a transient phrenic nerve injury. Two patients were documented with sustained atrial tachycardia (AT). Mapping in 2 patients showed a macro reentry AT due to gaps in the ablation lines and further ablation was needed. No other complications including PV stenosis occurred. Conclusions: The present study demonstrated that RFCA is an effective and feasible treatment for persistent or permanent AF.