Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation

Hakan Oral*, Bradley P. Knight, Hiroshi Tada, Mehmet Özaydin, Aman Chugh, Sohail Hassan, Christoph Scharf, Steve W K Lai, Radmira Greenstein, Frank Pelosi, S. Adam Strickberger, Fred Morady

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

927 Scopus citations

Abstract

Background - The pulmonary veins (PVs) have been demonstrated to often play an important role in generating atrial fibrillation (AF). The purpose of this study was to determine the safety and efficacy of segmental PV isolation in patients with paroxysmal or persistent AF. Methods and Results - In 70 consecutive patients (mean age, 53±11 years) with paroxysmal (58) or persistent (12) AF, segmental PV isolation guided by ostial PV potentials was performed. The left superior, left inferior, and right superior PVs were targeted for isolation in all patients, and the right inferior PV was isolated in 20 patients. Among the 230 targeted PVs, 217 (94%) were completely isolated, with a mean of 6.5±4.2 minutes of radiofrequency energy applied at a maximum power setting of 35 W. A second PV isolation procedure was performed in 6 patients (9%). At 5 months of follow-up, 70% of patients with paroxysmal and 22% of patients with persistent AF were free from recurrent AF (P<0.001), and 83% of patients with paroxysmal AF were either free of symptomatic AF or had significant improvement. Among various clinical characteristics, only paroxysmal AF was an independent predictor of freedom from recurrence of AF (P<0.05). One patient developed unilateral quadrantopsia after the procedure. There were no other complications. Conclusions - With a segmental isolation approach that targets at least 3 PVs, a clinically satisfactory result can be achieved in >80% of patients with paroxysmal AF. The clinical efficacy of pulmonary vein isolation is much lower when AF is persistent than when it is paroxysmal.

Original languageEnglish (US)
Pages (from-to)1077-1081
Number of pages5
JournalCirculation
Volume105
Issue number9
DOIs
StatePublished - Mar 5 2002

Keywords

  • Atrium
  • Catheter ablation
  • Fibrillation
  • Pulmonary vein

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation'. Together they form a unique fingerprint.

Cite this