Tuesday, June 12, 2007
Hertz centrum bad Krozingen
Submitted on November 3, 2006
Accepted on April 9, 2007
Small or Large Isolation Areas Around the Pulmonary Veins for the Treatment of Atrial Fibrillation? Results From a Prospective Randomized Study
Thomas Arentz MD*, Reinhold Weber MD, Gerd Bürkle MD, Claudia Herrera MD, Thomas Blum MD, Jochem Stockinger MD, Jan Minners MD, PhD, Franz Josef Neumann MD, and Dietrich Kalusche MD
From Herz-Zentrum, Bad Krozingen, Germany.
* To whom correspondence should be addressed. E-mail: thomas.arentz@herzzentrum.de.
Background--Pulmonary vein (PV) isolation is a promising new treatment for atrial fibrillation (AF). We hypothesized that isolation of large areas around both ipsilateral PVs with verification of conduction block is more effective than the isolation of each individual PV.
Methods and Results--A total of 110 patients, 67 with paroxysmal AF and 43 with persistent AF, were randomly assigned to undergo either isolation of each individual PV or isolation of large areas around both ipsilateral PVs. The isolation of each individual PV was an electrophysiologically guided, ostial segmental ablation with a 64-pole basket catheter or a 20-pole circular mapping catheter (group I). Isolation of large areas was performed around the 2 ipsilateral veins with a nonfluoroscopic navigation system and a circular 20-pole mapping catheter for verification of conduction block (group II). In both groups, an irrigated-tip ablation catheter (25 to 35 W) was used to achieve complete isolation. Procedure and ablation times were longer in group II, whereas fluoroscopic time was significantly shorter (P≤0.001). After a follow-up period of 15±4 months, 27 patients in group I (49%) and 37 patients in group II (67%) remained free of symptoms of AF and had no AF or atrial flutter during repetitive Holter monitoring without antiarrhythmic drug treatment after a single procedure (P≤0.05).
Conclusions--The rate of success was significantly higher and fluoroscopy times were significantly lower in the group with large isolation areas around both ipsilateral PVs than in those who underwent individual PV isolation.
Key words: arrhythmia • mapping • catheter ablation • fibrillation • tachyarrhythmias
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
CIRCULATION ART, THRO, VASC BIO ALL AHA JOURNALS
CIRCULATION RESEARCH HYPERTENSION STROKE
Copyright © 2007 by the American Heart Association.
Accepted on April 9, 2007
Small or Large Isolation Areas Around the Pulmonary Veins for the Treatment of Atrial Fibrillation? Results From a Prospective Randomized Study
Thomas Arentz MD*, Reinhold Weber MD, Gerd Bürkle MD, Claudia Herrera MD, Thomas Blum MD, Jochem Stockinger MD, Jan Minners MD, PhD, Franz Josef Neumann MD, and Dietrich Kalusche MD
From Herz-Zentrum, Bad Krozingen, Germany.
* To whom correspondence should be addressed. E-mail: thomas.arentz@herzzentrum.de.
Background--Pulmonary vein (PV) isolation is a promising new treatment for atrial fibrillation (AF). We hypothesized that isolation of large areas around both ipsilateral PVs with verification of conduction block is more effective than the isolation of each individual PV.
Methods and Results--A total of 110 patients, 67 with paroxysmal AF and 43 with persistent AF, were randomly assigned to undergo either isolation of each individual PV or isolation of large areas around both ipsilateral PVs. The isolation of each individual PV was an electrophysiologically guided, ostial segmental ablation with a 64-pole basket catheter or a 20-pole circular mapping catheter (group I). Isolation of large areas was performed around the 2 ipsilateral veins with a nonfluoroscopic navigation system and a circular 20-pole mapping catheter for verification of conduction block (group II). In both groups, an irrigated-tip ablation catheter (25 to 35 W) was used to achieve complete isolation. Procedure and ablation times were longer in group II, whereas fluoroscopic time was significantly shorter (P≤0.001). After a follow-up period of 15±4 months, 27 patients in group I (49%) and 37 patients in group II (67%) remained free of symptoms of AF and had no AF or atrial flutter during repetitive Holter monitoring without antiarrhythmic drug treatment after a single procedure (P≤0.05).
Conclusions--The rate of success was significantly higher and fluoroscopy times were significantly lower in the group with large isolation areas around both ipsilateral PVs than in those who underwent individual PV isolation.
Key words: arrhythmia • mapping • catheter ablation • fibrillation • tachyarrhythmias
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
CIRCULATION ART, THRO, VASC BIO ALL AHA JOURNALS
CIRCULATION RESEARCH HYPERTENSION STROKE
Copyright © 2007 by the American Heart Association.
# posted by roodbont @ 1:30 AM 
