Double multielectrode mapping catheters facilitate radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins

Ming Hsiung Hsieh, Shih Ann Chen, Ching Tai Tai, Chin Feng Tsai, V. S. Prakash, Wen Chung Yu, Chuen Chia Liu, Yu An Ding, Mau Song Chang

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

Ablation of Focal AF. Introduction: Several reports have demonstrated that focal atrial fibrillation (AF) may arise from pulmonary veins (PVs). The purpose of this study was to investigate the safety and efficacy of using double multielectrode mapping catheters in ablation of focal AF. Methods and Results: Forty-two patients (30 men, 12 women, age 65 ± 14 years) with frequent attacks of paroxysmal AF were referred for catheter ablation. After atrial transseptal procedure, two long sheaths were put into the left atrium. Two decapolar catheters were put into the right superior PV (RSPV) and left superior PV (LSPV), or inferior PVs if necessary, guided by pulmonary venography. All the patients had spontaneous initiation of AF either during baseline (2 patients), after isoproterenol infusion (8 patients) or high- dose adenosine (2 patients), after short duration burst pacing under isoproterenol (14 patients), or after cardioversion of pacing-induced AF (16 patients). The trigger points of AF were from the LSPV (12 patients), RSPV (8 patients), and both superior PVs (19 patients). The trigger points from PVs (total 61 points) were 18 (30%) in the ostium of PVs and 43 inside the PVs (9 to 40 mm). After 6 ± 3 applications of radiofrequency energy, 57 of 61 triggers were completely eliminated, and the other 4 triggers were partially eliminated. During a follow-up period of 8 ± 2 months, 37 patients (88%) were free of symptomatic AF without any antiarrhythmic drugs. Twenty patients received a transesophageal echocardiogram, and 19 showed small atrial septal defects (2.8 ± 1.2 mm) with trivial shunt. Fifteen defects closed spontaneously 1 month later. Conclusion: The technique using double multielectrode mapping catheters is a relatively safe and highly effective method for mapping and ablation of focal AF originating from PVs.

Original languageEnglish
Pages (from-to)136-144
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume10
Issue number2
Publication statusPublished - 1999
Externally publishedYes

Fingerprint

Catheter Ablation
Pulmonary Veins
Atrial Fibrillation
Catheters
Trigger Points
Isoproterenol
Electric Countershock
Atrial Heart Septal Defects
Phlebography
Anti-Arrhythmia Agents
Patient Rights
Heart Atria
Adenosine
Safety

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Double multielectrode mapping catheters facilitate radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins. / Hsieh, Ming Hsiung; Chen, Shih Ann; Tai, Ching Tai; Tsai, Chin Feng; Prakash, V. S.; Yu, Wen Chung; Liu, Chuen Chia; Ding, Yu An; Chang, Mau Song.

In: Journal of Cardiovascular Electrophysiology, Vol. 10, No. 2, 1999, p. 136-144.

Research output: Contribution to journalArticle

Hsieh, Ming Hsiung ; Chen, Shih Ann ; Tai, Ching Tai ; Tsai, Chin Feng ; Prakash, V. S. ; Yu, Wen Chung ; Liu, Chuen Chia ; Ding, Yu An ; Chang, Mau Song. / Double multielectrode mapping catheters facilitate radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins. In: Journal of Cardiovascular Electrophysiology. 1999 ; Vol. 10, No. 2. pp. 136-144.
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abstract = "Ablation of Focal AF. Introduction: Several reports have demonstrated that focal atrial fibrillation (AF) may arise from pulmonary veins (PVs). The purpose of this study was to investigate the safety and efficacy of using double multielectrode mapping catheters in ablation of focal AF. Methods and Results: Forty-two patients (30 men, 12 women, age 65 ± 14 years) with frequent attacks of paroxysmal AF were referred for catheter ablation. After atrial transseptal procedure, two long sheaths were put into the left atrium. Two decapolar catheters were put into the right superior PV (RSPV) and left superior PV (LSPV), or inferior PVs if necessary, guided by pulmonary venography. All the patients had spontaneous initiation of AF either during baseline (2 patients), after isoproterenol infusion (8 patients) or high- dose adenosine (2 patients), after short duration burst pacing under isoproterenol (14 patients), or after cardioversion of pacing-induced AF (16 patients). The trigger points of AF were from the LSPV (12 patients), RSPV (8 patients), and both superior PVs (19 patients). The trigger points from PVs (total 61 points) were 18 (30{\%}) in the ostium of PVs and 43 inside the PVs (9 to 40 mm). After 6 ± 3 applications of radiofrequency energy, 57 of 61 triggers were completely eliminated, and the other 4 triggers were partially eliminated. During a follow-up period of 8 ± 2 months, 37 patients (88{\%}) were free of symptomatic AF without any antiarrhythmic drugs. Twenty patients received a transesophageal echocardiogram, and 19 showed small atrial septal defects (2.8 ± 1.2 mm) with trivial shunt. Fifteen defects closed spontaneously 1 month later. Conclusion: The technique using double multielectrode mapping catheters is a relatively safe and highly effective method for mapping and ablation of focal AF originating from PVs.",
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T1 - Double multielectrode mapping catheters facilitate radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins

AU - Hsieh, Ming Hsiung

AU - Chen, Shih Ann

AU - Tai, Ching Tai

AU - Tsai, Chin Feng

AU - Prakash, V. S.

AU - Yu, Wen Chung

AU - Liu, Chuen Chia

AU - Ding, Yu An

AU - Chang, Mau Song

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AB - Ablation of Focal AF. Introduction: Several reports have demonstrated that focal atrial fibrillation (AF) may arise from pulmonary veins (PVs). The purpose of this study was to investigate the safety and efficacy of using double multielectrode mapping catheters in ablation of focal AF. Methods and Results: Forty-two patients (30 men, 12 women, age 65 ± 14 years) with frequent attacks of paroxysmal AF were referred for catheter ablation. After atrial transseptal procedure, two long sheaths were put into the left atrium. Two decapolar catheters were put into the right superior PV (RSPV) and left superior PV (LSPV), or inferior PVs if necessary, guided by pulmonary venography. All the patients had spontaneous initiation of AF either during baseline (2 patients), after isoproterenol infusion (8 patients) or high- dose adenosine (2 patients), after short duration burst pacing under isoproterenol (14 patients), or after cardioversion of pacing-induced AF (16 patients). The trigger points of AF were from the LSPV (12 patients), RSPV (8 patients), and both superior PVs (19 patients). The trigger points from PVs (total 61 points) were 18 (30%) in the ostium of PVs and 43 inside the PVs (9 to 40 mm). After 6 ± 3 applications of radiofrequency energy, 57 of 61 triggers were completely eliminated, and the other 4 triggers were partially eliminated. During a follow-up period of 8 ± 2 months, 37 patients (88%) were free of symptomatic AF without any antiarrhythmic drugs. Twenty patients received a transesophageal echocardiogram, and 19 showed small atrial septal defects (2.8 ± 1.2 mm) with trivial shunt. Fifteen defects closed spontaneously 1 month later. Conclusion: The technique using double multielectrode mapping catheters is a relatively safe and highly effective method for mapping and ablation of focal AF originating from PVs.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Pulmonary vein

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