Incidence and Time Course of Early Recovery of Pulmonary Vein Conduction after Catheter Ablation of Atrial Fibrillation
- 21 February 2007
- journal article
- clinical trial
- Published by Wiley in Journal of Cardiovascular Electrophysiology
- Vol. 18 (4) , 387-391
- https://doi.org/10.1111/j.1540-8167.2007.00760.x
Abstract
Background: Although it is well recognized that recovery of pulmonary vein (PV) conduction is common among patients who fail atrial fibrillation (AF) ablation, little is known about the precise time course of recurrence. Objective: To determine the incidence and time course of early recurrence of conduction after PV isolation during AF ablation. Methods: The patient population was composed of 14 consecutive patients (9 men [64%]; age 56 ± 7 years) with AF who underwent radiofrequency catheter ablation via circumferential ablation with PV isolation, determined by a circular mapping catheter. After successful isolation of the PVs, repeat circular electrode recordings from each PV were obtained at 30 and 60 minutes. Results: After complete isolation of all PVs, early PV recurrence was observed in 13 (93%) patients and 26 veins (50%). Seventeen veins (33%) showed a first recurrence at 30 minutes, while nine veins (17%) showed a first recurrence at 60 minutes. Conclusion: The results reveal an extremely high rate of early recurrence of PV conduction following AF ablation. It is particularly notable that about one‐fifth of the veins remained isolated at 30 minutes, but subsequently developed recurrence between 30 and 60 minutes. Of the veins that showed early recurrence, one‐third developed a first recurrence at 60 minutes. These findings suggest that AF ablation procedures should incorporate a 60‐minute waiting period after initial isolation in order to detect early recurrence of conduction.Keywords
This publication has 13 references indexed in Scilit:
- Long‐Term Safety and Efficacy of Circumferential Ablation with Pulmonary Vein IsolationJournal of Cardiovascular Electrophysiology, 2006
- Initial Experience in the Use of Integrated Electroanatomic Mapping with Three‐Dimensional MR/CT Images to Guide Catheter Ablation of Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2006
- Response of Atrial Fibrillation to Pulmonary Vein Antrum Isolation Is Directly Related to Resumption and Delay of Pulmonary Vein ConductionCirculation, 2005
- Complete Isolation of Left Atrium Surrounding the Pulmonary VeinsCirculation, 2004
- Left Atrial–Esophageal Fistula Following Radiofrequency Catheter Ablation of Atrial FibrillationJournal of Cardiovascular Electrophysiology, 2004
- Atrio-Esophageal Fistula as a Complication of Percutaneous Transcatheter Ablation of Atrial FibrillationCirculation, 2004
- Resumption of Electrical Conduction in Previously Isolated Pulmonary VeinsCirculation, 2004
- Prospective Assessment of Late Conduction Recurrence Across Radiofrequency Lesions Producing Electrical Disconnection at the Pulmonary Vein Ostium in Patients With Atrial FibrillationCirculation, 2003
- Incidence and Location of Focal Atrial Fibrillation Triggers in Patients Undergoing Repeat Pulmonary Vein Isolation:Journal of Cardiovascular Electrophysiology, 2003
- Electrophysiologically guided ablation of the pulmonary veins for the curative treatment of atrial fibrillationAnnals of Medicine, 2000