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Persistency of left atrial linear lesions after radiofrequency catheter ablation for atrial fibrillation: Data from an invasive follow‐up electrophysiology study
Author(s) -
Mujović Nebojša,
Marinković Milan,
Marković Nebojša,
Stanković Goran,
Lip Gregory Y. H.,
BlomstromLundqvist Carina,
Bunch T. Jared,
Potpara Tatjana S.
Publication year - 2017
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.13322
Subject(s) - medicine , atrial fibrillation , pulmonary vein , cardiology , ablation , catheter ablation , left atrium , catheter , lesion , radiology , surgery
Background Data on the roof line (RL) and mitral isthmus line (MIL) reconnections after atrial fibrillation (AF) catheter ablation (CA) are scarce. Objective We studied the RL and MIL completeness and localization of reconnection sites in consecutive patients after their first‐ever AF‐CA. Methods We prospectively included 41 consecutive AF patients who underwent predefined lesion sets of two circumferential lines (CLs) for ipsilateral pulmonary vein isolation (PVI) combined with a RL and lateral MIL. Three months after CA, all patients underwent invasive follow‐up procedure for line persistency evaluation, irrespective of clinical outcome. Results At the time of index ablation, PVI‐CLs, RL, and MIL was completed in 41 (100%), 39 (95%), and 34 (83%) of patients, respectively. At the 3‐month follow‐up procedure, reconnections of PVI‐CLs, RL, and MIL were found in 61% (25/41), 28% (11/39), and 24% (8/34) of patients, respectively. The 3‐month reconnections were located commonly in the anterior and posterior PVI‐CL segments, and rarely in the right third of RL and in the posterior part of MIL. The 3‐month reconnections were rarely seen at the sites of acute reconnections during index procedure (6%, 20%, and 25% of the PVI‐CL segments, RL segments, and MIL segments, respectively). Conclusions To our knowledge, this is the first study systematically investigating the reconnection of standardized left atrium linear lesions such as RL and MIL after RF‐CA for AF in consecutive patients. The RL and MIL 3‐month reconnection rates were relatively low (28% and 24%), with poor anatomical concordance between the sites with acute and 3‐month reconnections.