Catheter ablation of chronic atrial fibrillation using circumferential and complex linear lesions in the left atrium: modes of arrhythmia termination and long-term clinical outcome
Authors:
M. Fiala; J. Chovančík; R. Neuwirth; R. Nevřalová; O. Jiravský; H. Szymeczek; D. Wojnarová; R. Moravec; L. Škňouřil; M. Dorda; J. Januška; I. Nykl; J. Černý; M. Branny
Authors‘ workplace:
Oddělení kardiologie, Nemocnice Podlesí a. s., Třinec, přednosta prim. MUDr. Marian Branny
Published in:
Vnitř Lék 2007; 53(3): 231-241
Category:
Original Contributions
Overview
Objective:
Catheter ablation for chronic atrial fibrillation was performed in 82 patients (18 females, aged 54 ± 10 years), in 112 ablation procedures. Mean duration of the chronic phase of atrial fibrillation was 28 ± 28 months. Before ablation, amiodarone was administered without effect to 74 (90 %) patients, and was counter-indicated in 8 (10 %) patients. Ablation strategy consisted of circumferential lesions around the pulmonary veins and of complex linear lesions in the left atrium. Full pulmonary vein antra isolation, and sinus rhythm restoration, or at least converting atrial fibrillation into the left atrial tachycardia, were the procedure end points.
Results:
Sinus rhythm was restored by ablation at least in one of the ablation procedures in 43 (52 %) patients. During the follow-up period spanning 17.3 ± 11.6 months after the last ablation, stable sinus rhythm was achieved in 63 (77 %) patients, of whom 38 (60 %) had their sinus rhythm restored by ablation and another 14 (22 %) their atrial fibrillation converted into the left atrial tachycardia. Of the 63 patients with stable sinus rhythm, class I or III antiarrhythmic medication has been maintained in 21 (33 %) patients, and amiodarone has been taken by 13 (21 %) patients.
Conclusion:
Catheter ablation of chronic atrial fibrillation is potentially highly effective in long-term restoration of sinus rhythm.
Key words:
atrial fibrillation – chronic atrial fibrillation – catheter ablation – left atrium
Sources
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