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The Impact of Catheter Ablation in the Interpulmonary Isthmus on Atrial Fibrillation Ablation Outcomes: A Randomized Study
Author(s) -
LETSAS KONSTANTINOS P.,
EFREMIDIS MICHAEL,
VLACHOS KONSTANTINOS,
KARLIS DIMITRIOS,
LIONI LOUIZA,
ASVESTAS DIMITRIOS,
VALKANAS KOSMAS,
MIHAS CONSTANTINOS C.,
SIDERIS ANTONIOS
Publication year - 2014
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/jce.12399
Subject(s) - medicine , pulmonary vein , ablation , atrial fibrillation , catheter ablation , cardiology , fluoroscopy , antrum , radiofrequency ablation , paroxysmal atrial fibrillation , catheter , surgery , stomach
Catheter Ablation in the Interpulmonary Isthmus Introduction Previous studies have underscored the importance of the interpulmonary isthmus in the initiation and maintenance of atrial fibrillation (AF). The efficacy of additional radiofrequency energy delivery in the interpulmonary isthmus following pulmonary vein antral isolation (PVAI) was investigated. Methods and Results A total of 76 patients (49 males, mean age 56.8 ± 10.3) with drug‐resistant paroxysmal (n = 64) and short‐lasting persistent AF (n = 12) underwent PVAI. Patients were then randomly assigned to receive either “no further ablation” (group I, n = 38) or additional lesions in the interpulmonary isthmus of both ipsilateral pulmonary veins (group II, n = 38). There were no significant differences between study groups regarding the clinical and echocardiographic data. A trend towards a longer fluoroscopy time was observed in group II (P = 0.076). After a mean follow‐up period of 11.1 ± 2.6 months, 22 patients in group I (57.9%) and 25 patients in group II (65.8%) were free from arrhythmia recurrence without any antiarrhythmic drug treatment after a single ablation procedure. The Kaplan–Meier arrhythmia‐free survival curves showed no significant differences between study groups (P = 0.460). Conclusions Additional lesions in the interpulmonary isthmus following PVAI do not have incremental value in preventing AF recurrence.