2002
DOI: 10.1161/01.cir.0000019585.91146.ab
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Electrical Connections Between Pulmonary Veins

Abstract: Background-Electrical disconnection of the myocardial extensions into arrhythmogenic pulmonary veins (PVs) is recognized as a curative technique for paroxysmal atrial fibrillation (AF). However, the presence of electrical connections between the PVs, which may make achievement of PV disconnection difficult, has not been systematically evaluated. Methods and Results-Forty-nine consecutive patients with drug-resistant AF underwent ostial radiofrequency (RF) catheter ablation of arrhythmogenic PVs with foci tri… Show more

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Cited by 164 publications
(16 citation statements)
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“…14 observed that sites of entry breakthrough may differ from exit breakthrough sites. Takahashi et al 15 reported residual PV–LA conduction via residual intervenous conduction in 14% of patients after apparent entry block at the superior PV ostium. Therefore, segmental ablation of entry fibres might be associated with residual exit conduction.…”
Section: Discussionmentioning
confidence: 99%
“…14 observed that sites of entry breakthrough may differ from exit breakthrough sites. Takahashi et al 15 reported residual PV–LA conduction via residual intervenous conduction in 14% of patients after apparent entry block at the superior PV ostium. Therefore, segmental ablation of entry fibres might be associated with residual exit conduction.…”
Section: Discussionmentioning
confidence: 99%
“…The foregoing decade focussed on either time consuming electrophysiological guided direct ablation of each PV potential 20,21,22 or on a 3D electro-anatomical guided approach to electrically isolate the PVs by creating hemispheric or circumferential lesions at the PV ostium 23,24,25,26. Limitations of the approaches included smooth learning curves, the need for more than one transseptal catheter, prolonged PD, and high risk of complications.…”
Section: Discussionmentioning
confidence: 99%
“…Circumferential PV isolation is generally guided by three-dimensional (3D) electroanatomical mapping [68], fluoroscopy [9], and/or intracardiac echocardiography (ICE) [10, 11]. However, only ICE offers the unique ability to image the LA in real time during the course of the procedure and to identify all structures which are important for the ablation.…”
Section: Introductionmentioning
confidence: 99%
“…Endpoints for a circumferential PV isolation procedure are either amplitude reduction within the ablated area [6, 8], elimination of the PV potentials recorded from the mapping catheter within the ipsilateral PV [7, 9, 10, 1215], and/or exit block from the PV [16]. To achieve these endpoints in a safe and effective manner, ICE allows precise guidance of catheter-based ablations of arrhythmic foci in the PVs [17] and directly monitors, for example, tissue changes or development of microbubbles under ablation.…”
Section: Introductionmentioning
confidence: 99%