Journal of Arrhythmia (Jan 2007)

Efficacy and Safety of Catheter Ablation for Persistent or Permanent Atrial Fibrillation

  • Soichi Muraoka, MD,
  • Chiharu Mitsutake, MD,
  • Hideo Takashima, MD,
  • Hideko Nakashima, MD,
  • Tomoo Yasuda, MD,
  • Naomichi Matsumoto, MD,
  • Koichiro Kumagai, MD,
  • Keijiro Saku, MD

DOI
https://doi.org/10.1016/S1880-4276(07)80004-4
Journal volume & issue
Vol. 23, no. 3
pp. 229 – 235

Abstract

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Introduction: Radiofrequency catheter ablation (RFCA) that targets pulmonary veins (PV) is an established treatment for paroxysmal atrial fibrillation (PAF). Recent studies have demonstrated that RFCA can eliminate PAF in over 90% of patients. However, the effectiveness for persistent or permanent AF has not been clarified. Methods and Results: 27 patients (29%) had persistent or permanent AF. RFCA including PV antrum isolation (PVAI) was performed using a circular mapping catheter in the patients with persistent or permanent AF. Four patients (15%) underwent only PVAI. Thirteen patients (48%) underwent PVAI and left atrium roof and/or mitral isthmus linear ablation. Ten patients (37%) underwent PVAI and RFCA to an area with complex fractionated atrial electrograms. All patients were observed for over a year. After repeat ablation at mean followup of 16 ± 5 months, 23 patients (85%) had normal sinus rhythm and were free of symptomatic AF or atrial flutter. Three patients required antiarrhythmic drugs to maintain sinus rhythm during follow-up period. One patient had a transient phrenic nerve injury. Two patients were documented with sustained atrial tachycardia (AT). Mapping in 2 patients showed a macro reentry AT due to gaps in the ablation lines and further ablation was needed. No other complications including PV stenosis occurred. Conclusions: The present study demonstrated that RFCA is an effective and feasible treatment for persistent or permanent AF.

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