Characteristics and outcome in patients receiving multiple (more than two) catheter ablation procedures for paroxysmal atrial fibrillation

Li Wei Lo, Ching Tai Tai, Yenn Jiang Lin, Shih Lin Chang, Wanwarang Wongcharoen, Ming Hsiung Hsieh, Ta Chuan Tuan, Ameya R. Udyavar, Yu Feng Hu, Yi Jen Chen, Shuo Ju Chiang, Hsuan Ming Tsao, Shih Ann Chen

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Multiple PV Isolation Procedures. Background: The features of multiple catheter ablation procedures for paroxysmal atrial fibrillation (AF) are unknown. We aimed to investigate the electrophysiologic characteristics and the clinical outcomes in the patients with AF who received more than two ablation procedures. Methods: The study consisted of 15 consecutive patients (age 48 ± 14 years, 10 males) who had undergone three to five (3.3 ± 0.6) catheter ablation procedures for recurrent paroxysmal AF. Results: Ten patients had pulmonary vein (PV)-AF and one had AF originating from both PVs and the superior vena cava (SVC) in the first ablation procedure. All of them exhibited PV reconnection during the recurrent episodes. Four of the 15 patients had AF originating from non-PV foci (three from the SVC, one from the crista terminalis) in the first procedure, and two had AF recurrences due to recovered conduction from the SVC. In all patients with PV-AF recurrences, repeated PV isolation procedures could effectively eliminate the AF. The incidence of the need for additional LA linear ablation lesions was higher comparing between the first procedure and in the following ablation procedures (18% vs. 71%, P = 0.02). During a follow-up of 1.7 ± 1.1 years, 73% of the patients remained in sinus rhythm without any antiarrhythmic drugs after the final procedure. Conclusions: Recovered PV connection was the major cause of the AF recurrences despite undergoing multiple catheter ablation procedures. It is advisable to inspect all PVs during the AF recurrence. Repeated PV isolation plus left atrial linear ablations could effectively eliminate the AF with satisfactory outcomes.

Original languageEnglish
Pages (from-to)150-156
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume19
Issue number2
DOIs
Publication statusPublished - Feb 2008
Externally publishedYes

Fingerprint

Catheter Ablation
Atrial Fibrillation
Pulmonary Veins
Superior Vena Cava
Recurrence
Anti-Arrhythmia Agents
Veins

Keywords

  • Atrial fibrillation
  • Pulmonary veins
  • Safety

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Characteristics and outcome in patients receiving multiple (more than two) catheter ablation procedures for paroxysmal atrial fibrillation. / Lo, Li Wei; Tai, Ching Tai; Lin, Yenn Jiang; Chang, Shih Lin; Wongcharoen, Wanwarang; Hsieh, Ming Hsiung; Tuan, Ta Chuan; Udyavar, Ameya R.; Hu, Yu Feng; Chen, Yi Jen; Chiang, Shuo Ju; Tsao, Hsuan Ming; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 19, No. 2, 02.2008, p. 150-156.

Research output: Contribution to journalArticle

Lo, Li Wei ; Tai, Ching Tai ; Lin, Yenn Jiang ; Chang, Shih Lin ; Wongcharoen, Wanwarang ; Hsieh, Ming Hsiung ; Tuan, Ta Chuan ; Udyavar, Ameya R. ; Hu, Yu Feng ; Chen, Yi Jen ; Chiang, Shuo Ju ; Tsao, Hsuan Ming ; Chen, Shih Ann. / Characteristics and outcome in patients receiving multiple (more than two) catheter ablation procedures for paroxysmal atrial fibrillation. In: Journal of Cardiovascular Electrophysiology. 2008 ; Vol. 19, No. 2. pp. 150-156.
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abstract = "Multiple PV Isolation Procedures. Background: The features of multiple catheter ablation procedures for paroxysmal atrial fibrillation (AF) are unknown. We aimed to investigate the electrophysiologic characteristics and the clinical outcomes in the patients with AF who received more than two ablation procedures. Methods: The study consisted of 15 consecutive patients (age 48 ± 14 years, 10 males) who had undergone three to five (3.3 ± 0.6) catheter ablation procedures for recurrent paroxysmal AF. Results: Ten patients had pulmonary vein (PV)-AF and one had AF originating from both PVs and the superior vena cava (SVC) in the first ablation procedure. All of them exhibited PV reconnection during the recurrent episodes. Four of the 15 patients had AF originating from non-PV foci (three from the SVC, one from the crista terminalis) in the first procedure, and two had AF recurrences due to recovered conduction from the SVC. In all patients with PV-AF recurrences, repeated PV isolation procedures could effectively eliminate the AF. The incidence of the need for additional LA linear ablation lesions was higher comparing between the first procedure and in the following ablation procedures (18{\%} vs. 71{\%}, P = 0.02). During a follow-up of 1.7 ± 1.1 years, 73{\%} of the patients remained in sinus rhythm without any antiarrhythmic drugs after the final procedure. Conclusions: Recovered PV connection was the major cause of the AF recurrences despite undergoing multiple catheter ablation procedures. It is advisable to inspect all PVs during the AF recurrence. Repeated PV isolation plus left atrial linear ablations could effectively eliminate the AF with satisfactory outcomes.",
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T1 - Characteristics and outcome in patients receiving multiple (more than two) catheter ablation procedures for paroxysmal atrial fibrillation

AU - Lo, Li Wei

AU - Tai, Ching Tai

AU - Lin, Yenn Jiang

AU - Chang, Shih Lin

AU - Wongcharoen, Wanwarang

AU - Hsieh, Ming Hsiung

AU - Tuan, Ta Chuan

AU - Udyavar, Ameya R.

AU - Hu, Yu Feng

AU - Chen, Yi Jen

AU - Chiang, Shuo Ju

AU - Tsao, Hsuan Ming

AU - Chen, Shih Ann

PY - 2008/2

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N2 - Multiple PV Isolation Procedures. Background: The features of multiple catheter ablation procedures for paroxysmal atrial fibrillation (AF) are unknown. We aimed to investigate the electrophysiologic characteristics and the clinical outcomes in the patients with AF who received more than two ablation procedures. Methods: The study consisted of 15 consecutive patients (age 48 ± 14 years, 10 males) who had undergone three to five (3.3 ± 0.6) catheter ablation procedures for recurrent paroxysmal AF. Results: Ten patients had pulmonary vein (PV)-AF and one had AF originating from both PVs and the superior vena cava (SVC) in the first ablation procedure. All of them exhibited PV reconnection during the recurrent episodes. Four of the 15 patients had AF originating from non-PV foci (three from the SVC, one from the crista terminalis) in the first procedure, and two had AF recurrences due to recovered conduction from the SVC. In all patients with PV-AF recurrences, repeated PV isolation procedures could effectively eliminate the AF. The incidence of the need for additional LA linear ablation lesions was higher comparing between the first procedure and in the following ablation procedures (18% vs. 71%, P = 0.02). During a follow-up of 1.7 ± 1.1 years, 73% of the patients remained in sinus rhythm without any antiarrhythmic drugs after the final procedure. Conclusions: Recovered PV connection was the major cause of the AF recurrences despite undergoing multiple catheter ablation procedures. It is advisable to inspect all PVs during the AF recurrence. Repeated PV isolation plus left atrial linear ablations could effectively eliminate the AF with satisfactory outcomes.

AB - Multiple PV Isolation Procedures. Background: The features of multiple catheter ablation procedures for paroxysmal atrial fibrillation (AF) are unknown. We aimed to investigate the electrophysiologic characteristics and the clinical outcomes in the patients with AF who received more than two ablation procedures. Methods: The study consisted of 15 consecutive patients (age 48 ± 14 years, 10 males) who had undergone three to five (3.3 ± 0.6) catheter ablation procedures for recurrent paroxysmal AF. Results: Ten patients had pulmonary vein (PV)-AF and one had AF originating from both PVs and the superior vena cava (SVC) in the first ablation procedure. All of them exhibited PV reconnection during the recurrent episodes. Four of the 15 patients had AF originating from non-PV foci (three from the SVC, one from the crista terminalis) in the first procedure, and two had AF recurrences due to recovered conduction from the SVC. In all patients with PV-AF recurrences, repeated PV isolation procedures could effectively eliminate the AF. The incidence of the need for additional LA linear ablation lesions was higher comparing between the first procedure and in the following ablation procedures (18% vs. 71%, P = 0.02). During a follow-up of 1.7 ± 1.1 years, 73% of the patients remained in sinus rhythm without any antiarrhythmic drugs after the final procedure. Conclusions: Recovered PV connection was the major cause of the AF recurrences despite undergoing multiple catheter ablation procedures. It is advisable to inspect all PVs during the AF recurrence. Repeated PV isolation plus left atrial linear ablations could effectively eliminate the AF with satisfactory outcomes.

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KW - Pulmonary veins

KW - Safety

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