Pulmonary Vein Isolation for Treatment of Atrial Fibrillation:

Seshadri, Niranjan; Marrouche, Nassir F.; Wilber, David J.; Packer, Douglas L.

doi:10.1046/j.1460-9592.2003.t01-1-00244.x

Cited by 23 publications

(13 citation statements)

References 19 publications

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“…In the present study, 3 patients with focal AT also experienced recurrent AF, and elimination of focal AT prevented recurrent AF. In keeping with another recent study, 14 these findings suggest that non-PV foci can trigger AF. CPVA may be unmasking preexisting AT foci that were drivers for AF, but after substrate modification, conduction does not degenerate into AF.…”

Section: Focal Atsupporting

confidence: 92%

Prevention of Iatrogenic Atrial Tachycardia After Ablation of Atrial Fibrillation

et al. 2004

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Background-Circumferential pulmonary vein ablation (CPVA) is effective in curing atrial fibrillation (AF), but new-onset left atrial tachycardia (AT) is a potential complication. We evaluated whether a modified CPVA approach including additional ablation lines on posterior wall and the mitral isthmus would reduce the incidence of AT after PV ablation. Methods and Results-A total of 560 patients (291 men, 52%; age, 56.5Ϯ7.3 years) entered the study; 280 were randomized to CPVA alone (group 1) and 280 to modified CPVA (group 2). The primary end point was freedom from AT after the procedure. In group 1, 28 patients (10%) experienced new-onset AT, and 41 (14.3%) experienced recurrent AF. In group 2, 11 patients (3.9%) experienced AT, and 36 (12.9%) had recurrent AF. Group 1 was more likely to experience AT than group 2 (Pϭ0.005). Freedom from AF after ablation was similar in both groups (Pϭ0.57). Among those in group 1, gap-related macroreentrant AT was documented in 23 of the 28 patients (82%), and focal AT was found in 5 (18%). In group 2, gap-related macroreentrant AT was found in 8 of the 11 patients (73%), and focal AT was seen in 3 (27%). Two patients in group 1 and 1 patient in group 2 had both AT and AF. The strongest predictor of AT was the presence of gaps (PϽ0.001). Conclusions-Modified

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Section: Focal Atsupporting

confidence: 92%

Prevention of Iatrogenic Atrial Tachycardia After Ablation of Atrial Fibrillation

et al. 2004

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“…Heparin bolus (100 to 150 U/kg) is always given before transseptal punctures. The patient is maintained on a heparin infusion rate of 15 to 20 U/kg/h (14,15) and the infusion rate is adjusted to keep the activated clotting time in the range of 350 to 450 s. The PVI procedure was performed according to a standard measure as previously described elsewhere (3,4,6,17,18). There is no consensus in the management of LA/LAA sludge.…”

Section: Methodsmentioning

confidence: 99%

Role of the CHADS2Score in the Evaluation of Thromboembolic Risk in Patients With Atrial Fibrillation Undergoing Transesophageal Echocardiography Before Pulmonary Vein Isolation

Puwanant

Varr

Shrestha

et al. 2009

Journal of the American College of Cardiology

226

134

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The prevalence of LA/LAA sludge/thrombus in patients with AF undergoing a pre-PVI screening TEE is very low (<2%) and increases significantly with higher CHADS(2) scores. This suggests that a screening TEE before PVI should be performed in patients with a CHADS(2) score of >or=1, and in patients with a CHADS(2) score of 0 when the AF is persistent and therapeutic anticoagulation has not been maintained for 4 weeks before the procedure.

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“…Recently, atrial fibrillation (AF) has been shown to arise from ectopic beats in the pulmonary veins 1,2 as well as from the superior vena cava (SVC) 3 . This has led to catheter ablation of these ectopic foci using radiofrequency energy as a novel treatment modality to cure for AF 4–8 . Patients after orthotopic heart transplantation (OHT) would be ideal to study the concept of ectopic foci initiated AF, as the recipient left atrium, SVC, and inferior vena cava (IVC) would be surgically isolated from the donor heart.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Atrial Fibrillation in Heart Transplant Patients: Long‐Term Follow‐Up

Khan

Kalahasti

Rajagopal

et al. 2006

Cardiovasc electrophysiol

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Pulmonary Vein Isolation for Treatment of Atrial Fibrillation:

Cited by 23 publications

References 19 publications

Prevention of Iatrogenic Atrial Tachycardia After Ablation of Atrial Fibrillation

Prevention of Iatrogenic Atrial Tachycardia After Ablation of Atrial Fibrillation

Role of the CHADS2Score in the Evaluation of Thromboembolic Risk in Patients With Atrial Fibrillation Undergoing Transesophageal Echocardiography Before Pulmonary Vein Isolation

Incidence of Atrial Fibrillation in Heart Transplant Patients: Long‐Term Follow‐Up

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