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Incidence and Time Course of Early Recovery of Pulmonary Vein Conduction after Catheter Ablation of Atrial Fibrillation
Author(s) -
CHEEMA AAMIR,
DONG JUN,
DALAL DARSHAN,
MARINE JOSEPH E.,
HENRIKSON CHARLES A.,
SPRAGG DAVID,
CHENG ALAN,
NAZARIAN SAMAN,
BILCHICK KENNETH,
SINHA SUNIL,
SCHERR DANIEL,
ALMASRY IBRAHIM,
HALPERIN HENRY,
BERGER RONALD,
CALKINS HUGH
Publication year - 2007
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2007.00760.x
Subject(s) - medicine , pulmonary vein , ablation , atrial fibrillation , catheter ablation , catheter , incidence (geometry) , cardiology , surgery , vein , physics , optics
Background: Although it is well recognized that recovery of pulmonary vein (PV) conduction is common among patients who fail atrial fibrillation (AF) ablation, little is known about the precise time course of recurrence. Objective: To determine the incidence and time course of early recurrence of conduction after PV isolation during AF ablation. Methods: The patient population was composed of 14 consecutive patients (9 men [64%]; age 56 ± 7 years) with AF who underwent radiofrequency catheter ablation via circumferential ablation with PV isolation, determined by a circular mapping catheter. After successful isolation of the PVs, repeat circular electrode recordings from each PV were obtained at 30 and 60 minutes.Results:After complete isolation of all PVs, early PV recurrence was observed in 13 (93%) patients and 26 veins (50%). Seventeen veins (33%) showed a first recurrence at 30 minutes, while nine veins (17%) showed a first recurrence at 60 minutes. Conclusion: The results reveal an extremely high rate of early recurrence of PV conduction following AF ablation. It is particularly notable that about one‐fifth of the veins remained isolated at 30 minutes, but subsequently developed recurrence between 30 and 60 minutes. Of the veins that showed early recurrence, one‐third developed a first recurrence at 60 minutes. These findings suggest that AF ablation procedures should incorporate a 60‐minute waiting period after initial isolation in order to detect early recurrence of conduction.