Inducibility of Paroxysmal Atrial Fibrillation by Isoproterenol and its Relation to the Mode of Onset of Atrial Fibrillation

Oral, Hakan; Crawford, Thomas; Frederick, Melissa; Gadeela, Nitesh; Wimmer, Alan P.; Dey, Sujoya; Sarrazin, J.; Kühne, Michael; Chalfoun, Nagib; Wells, Darryl; Good, D O Eric; Jongnarangsin, Krit; Chugh, Aman; Bogun, Frank; Pelosi, Frank; Morady, Fred

doi:10.1111/j.1540-8167.2007.01089.x

Cited by 62 publications

(53 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,[6][7][8][9]12,14,16,17,32 This differential observation can be attributed to the use of higher power and our standard practice of high-dose isoproterenol challenge to reveal PV reconnection at the end of the procedure, which confirms PV isolation and minimizes the likelihood of recovery of conduction in future. [48][49][50][51] Of note, our main indication for repeat ablations was not AF as reported in earlier studies. AFL (54.5%) was the major cause rather than AF (40.8%) in this trial.…”

Section: Discussionmentioning

confidence: 75%

Pulmonary Vein Antrum Isolation in Patients With Paroxysmal Atrial Fibrillation

Gökoğlan¹,

Mohanty²,

Güneş³

et al. 2016

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Background-We report the outcome of pulmonary vein (PV) antrum isolation in paroxysmal atrial fibrillation (AF) patients over more than a decade of follow-up. Methods and Results-A total of 513 paroxysmal AF patients (age 54±11 years, 73% males) undergoing catheter ablation at our institutions were included in this analysis. PV antrum isolation extended to the posterior wall between PVs plus empirical isolation of the superior vena cava was performed in all. Non-PV triggers were targeted during repeat procedure(s). Follow-up was performed quarterly for the first year and every 6 to 9 months thereafter. The outcome of this study was freedom from recurrent AF/atrial tachycardia. At 12 years, single-procedure arrhythmia-free survival was achieved in 58.7% of patients. Overall, the rate of recurrent arrhythmia (AF/atrial tachycardia) was 21% at 1 year, 11% between 1 and 3 years, 4% between 3 and 6 years, and 5.3% between 6 and 12 years. Repeat procedure was performed in 74% of patients. Reconnection in the PV antrum was found in 31% of patients after a single procedure and in no patients after 2 procedures. Non-PV triggers were found and targeted in all patients presenting with recurrent arrhythmia after ≥2 procedures. At 12 years, after multiple procedures, freedom from recurrent AF/atrial tachycardia was achieved in 87%. Conclusions-In patients with paroxysmal AF undergoing extended PV antrum isolation, the rate of late recurrence is lower than what previously reported with segmental or less extensive antral isolation. However, over more than a decade of follow-up, nearly 14% of patients developed recurrence because of new non-PV triggers. (Circ Arrhythm Electrophysiol. 2016;9:e003660.

show abstract

Section: Discussionmentioning

confidence: 75%

Pulmonary Vein Antrum Isolation in Patients With Paroxysmal Atrial Fibrillation

Gökoğlan¹,

Mohanty²,

Güneş³

et al. 2016

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

show abstract

“…Isoproterenol has been shown to be an important substance that stimulates the PV spontaneous activity (Lo et al, 2007;Oral et al, 2008). Although isoproterenol increased [Ca 2+ ] i , it did not induce spontaneous activity in the LA cardiomyocytes or PV cardiomyocytes without spontaneous activity.…”

Section: Effect Of Isoproterenol On the [Ca 2+ ] I Transients In The mentioning

confidence: 96%

Increased Ca2+ sparks and sarcoplasmic reticulum Ca2+ stores potentially determine the spontaneous activity of pulmonary vein cardiomyocytes

et al. 2008

View full text Add to dashboard Cite

“…Regarding clinical implications, during electrophysiologic studies and catheter ablation procedures in which isoproterenol infusion is utilized routinely, BIS appears to be an important tool for the optimization of TIVA [3,[12][13][14][15][16]. Di Biase et al demonstrated that patient movement may adversely affect ablation procedure results [12].…”

Section: Discussionmentioning

confidence: 99%

Isoproterenol infusion increases level of consciousness during catheter ablation of atrial fibrillation

O'Neill

Aizer

Linton

et al. 2012

J Interv Card Electrophysiol

View full text Add to dashboard Cite

show abstract

Inducibility of Paroxysmal Atrial Fibrillation by Isoproterenol and its Relation to the Mode of Onset of Atrial Fibrillation

Abstract: Isoproterenol at infusion rates up to 20 microg/min has a high sensitivity (88%) and specificity (95%) for induction of AF in patients with PAF, regardless of whether the clinical subtype is vagotonic, adrenergic, or random.

Cited by 62 publications

References 30 publications

Pulmonary Vein Antrum Isolation in Patients With Paroxysmal Atrial Fibrillation

Pulmonary Vein Antrum Isolation in Patients With Paroxysmal Atrial Fibrillation

Increased Ca2+ sparks and sarcoplasmic reticulum Ca2+ stores potentially determine the spontaneous activity of pulmonary vein cardiomyocytes

Isoproterenol infusion increases level of consciousness during catheter ablation of atrial fibrillation

Contact Info

Product

Resources

About