JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2015, Vol. 53 ›› Issue (3): 62-68.doi: 10.6040/j.issn.1671-7554.0.2014.029

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Effect of different circumferential pulmonary vein ablation endpoints on prognosis of atrial fibrillation patients:bidirectional block between pulmonary veins and left atrium

LI Man, ZHONG Jingquan, YUE Xin, ZHU Qing, ZHENG Zhaotong, RONG Bing, YI Shaolei, XIE Fei, ZHANG Yun   

  1. Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2014-01-12 Revised:2015-01-23 Online:2015-03-10 Published:2015-03-10

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Abstract: Objective To study the effect of different endpoints of ablation on the prognosis of atrial fibrillation (AF) patients. Methods A total of 137 patients with symptomatic AF (113 paroxysmal AF and 24 persistent AF) underwent 3D mapping. Radiofrequency energy was released in one encircling line to the endpoint of bidirectional conduction block between the pulmonary veins (PVs) and the left atrium (LA). After the postoperative observation with 30 minutes, isolation was successful in 110 AF patients (92 paroxysmal AF and 18 persistent AF). The 92 paroxysmal AF patients were divided into two groups:one group included 36 patients in which all PVPs disappeared, and the other group included 56 patients in which at least one of pulmonary vein potentials (PVPs) delayed by more than 30 ms. Results During two years follow-up, the recurrence of paroxysmal AF had no significant difference between the two groups (P=0.159). Conclusion Bidirectional block has no obvious effect on the living quality and recurrence of paroxysmal atrial fibrillation patients compared with those in which PVPs disappeared.

Key words: Atrial fibrillation, Bidirectional block, Ablation, Pulmonary veins, Atrium

CLC Number: 

  • R541.7
[1] Quyang F, Bänsch D, Ernst S, et al. Complete isolation of left atrium:surrounding the pulmonary veins:new insights from the Double-Lasso technique in paroxysmal atrial fibrillation[J]. Circulation, 2004, 110(15):2090-2096.
[2] Oral H, Scharf C, Chugh A, et al. Catheter ablation for paroxysmal atrial fibrillation:segmental pulmonary vein ostial ablation versus left atrial ablation[J]. Circulation, 2003, 108(19):2355-2360.
[3] Emst S, Ouyang F, Löber F, et al. Catheter-induced linear lesions in the left atrium in patients with atrial fibrillation[J]. J Am Coll Cardiol, 2003, 42(7):1271-1282.
[4] Cappato R, Calkins H, Chen SA, et al. Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation[J]. Circulation, 2005, 111(9):1100-1105.
[5] Chen S, Meng W, Sheng He D, et al. Blocking the pulmonary vein to left atrium conduction in addition to the entrance block enhances clinical efficacy in atrial fibrillation ablation[J]. Pacing Clin Electrophysiol, 2012, 35(5):524-531.
[6] De Bortoli A, Sun LZ, Solheim E, et al. Ablation effect indicated by impedance fall is correlated with contact force level during ablation for atrial fibrillation[J]. J Cardiovasc Electrophysiol, 2013, 24(11):1210-1215.
[7] 刘少稳, 杨延宗.射频导管消融肺静脉电隔离过程中残存静脉电位的鉴别诊断[J].中华心律失常学杂志, 2005, 9(3):197-203. LIU Shaowen, YANG Yanzong. The differential diagnosis of remaining venous potentials after radiofrequency catheter ablation[J]. Chinese Journal of Cardiac Arrhythmias, 2005, 9(3):197-203.
[8] Dong J, Liu X, Long D, et al. Single-catheter technique for pulmonary vein antrum isolation:is it sufficient to identify and close the residual gaps without a circular mapping catheter?[J]. J Cardiovasc Electrophysiol, 2009, 20(3):273-279.
[9] Cappato R, Calkins H, Chen SA, et al. Updated worldwide survey on the methods, efficacy and safety of catheter ablation for human atrial fibrillation[J]. Circ Arrhythm Electrophysiol, 2010, 3(1):32-38.
[10] Wylie JV Jr, Peters DC, Essebag V, et al. Left atrial function and scar after catheter ablation of atrial fibrillation[J]. Heart Rhythm, 2008, 5(5):656-662.
[11] Verma A, Kilicaslan F, Pisano E, et al. Response of atrial fibrillation to pulmonary vein antrum isolation is directly related to resumption and delay of pulmonary vein conduction[J]. Circulation, 2005, 112(5):627-635.
[12] Gerstenfeld EP, Callans DJ, Dixit S, et al. Incidence and location of focal atrial fibrillation triggers in patients undergoing repeat pulmonary vein isolation:implications for ablation strategies[J]. J Cardiovasc Electrophysiol, 2003, 14(7):685-690.
[13] Callans DJ, Gerstenfeld EP, Dixit S, et al. Efficacy of repeat pulmonary vein isolation procedures in patients with recurrent atrial fibrillation[J]. J Cardiovasc Electrophysiol, 2004, 15(9):1050-1055.
[14] Kurotobi T, Ito H, Inoue K, et al. Marshall vein as arrhythmogenic source in patients with atrial fibrillation:correlation between its anatomy and electrophysiological findings[J]. J Cardiovasc Electrophysiol, 2006, 17(10):1062-1067.
[15] Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins[J]. N Engl J Med, 1998, 339(10):659-666.
[16] Katritsis DG, Ellenbogen KA. Is isolation of all four pulmonary veins necessary in patients with paroxysmal atrial fibrillation?[J]. Pacing Clin Electrophysiol, 2004, 27(7):938-940.
[17] Off MK, Solheim E, Hoff PL, et al. Atrio-pulmonary vein conduction delay during pulmonary isolation for atrial fibrillation is related to vein anatomy, age, and focal activity[J]. Pacing Clin Electrophysiol, 2009, 32(Suppl 1):S207-210.
[18] Kumagai K, Naito S, Nakamura K, et al. ATP-induced dormant pulmonary veins originating from the carina region after circuferential pulmonary vein isolation of atrial fibrillation[J]. J Cardiovasc Electrophysiol, 2010, 21 (5):494-500.
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