A Combined Therapy Using Encircling Pulmonary Vein Isolation and Supplemental Segmental Ostial Isolation for the Treatment of Atrial Fibrillation

Naoya Tsuboi, MD; Yukihiko Yoshida, MD; Matsumoto Masaya, MD; Takashi Yamamoto, MD; Yutaka Aoyama, MD; Makoto Ishikawa, MD; Yasuhiro Ogura, MD; Hirohiko Suzuki, MD; Kentaro Yamashita, MD; Takashi Muramatsu, MD; Mamoru Nanasato, MD; Haruo Hirayama, MD; Teruo Itoh, MD; Taro Okada, MD; Takumi Yamada, MD; Yoshimasa Murakami, MD; Takahisa Kondo, MD; Yasuya Inden, MD; Toyoaki Murohara, MD; Itsuo Kodama, MD; Junji Toyama, MD

doi:10.1016/S1880-4276(06)80032-3

Journal of Arrhythmia (Jan 2006)

A Combined Therapy Using Encircling Pulmonary Vein Isolation and Supplemental Segmental Ostial Isolation for the Treatment of Atrial Fibrillation

Naoya Tsuboi, MD,
Yukihiko Yoshida, MD,
Matsumoto Masaya, MD,
Takashi Yamamoto, MD,
Yutaka Aoyama, MD,
Makoto Ishikawa, MD,
Yasuhiro Ogura, MD,
Hirohiko Suzuki, MD,
Kentaro Yamashita, MD,
Takashi Muramatsu, MD,
Mamoru Nanasato, MD,
Haruo Hirayama, MD,
Teruo Itoh, MD,
Taro Okada, MD,
Takumi Yamada, MD,
Yoshimasa Murakami, MD,
Takahisa Kondo, MD,
Yasuya Inden, MD,
Toyoaki Murohara, MD,
Itsuo Kodama, MD,
Junji Toyama, MD

Affiliations

Naoya Tsuboi, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Yukihiko Yoshida, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Matsumoto Masaya, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Takashi Yamamoto, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Yutaka Aoyama, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Makoto Ishikawa, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Yasuhiro Ogura, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Hirohiko Suzuki, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Kentaro Yamashita, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Takashi Muramatsu, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Mamoru Nanasato, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Haruo Hirayama, MD: Cardiovascular Center, Nagoya Daini Red Cross Hospital
Teruo Itoh, MD: Kokusai Central Clinic
Taro Okada, MD: Aichi Cardiovascular and Respiratory Center
Takumi Yamada, MD: Aichi Cardiovascular and Respiratory Center
Yoshimasa Murakami, MD: Aichi Cardiovascular and Respiratory Center
Takahisa Kondo, MD: Department of Cardiology, Nagoya University Graduate School of Medicine
Yasuya Inden, MD: Department of Cardiology, Nagoya University Graduate School of Medicine
Toyoaki Murohara, MD: Department of Cardiology, Nagoya University Graduate School of Medicine
Itsuo Kodama, MD: Research Institute of Environmental Medicine, Nagoya University
Junji Toyama, MD: Aichi Hospital Management Bureau

DOI: https://doi.org/10.1016/S1880-4276(06)80032-3
Journal volume & issue: Vol. 22, no. 4
pp. 225 – 233

Abstract

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Electrical isolation of the pulmonary veins (PV) has become a curative treatment for patients with atrial fibrillation (AF). Recently, there have been many reports that circumferential PV isolation (CPI) on the atrial side has a better outcome than segmental ostial PV isolation (SOPI). However, reports on the combination of CPI using electoroanatomic mapping and SOPI using a circular mapping catheter have been few. The aim of the present study was to investigate the efficacy and safety of a combined therapy using CPI and supplemental SOPI for the treatment of AF. We performed CPI in 120 patients with drugrefractory AF. In 27 of those patients CPI resulted in a disconnection between the left atrium (LA) and PVs. In the remaining patients, supplemental SOPI completed the LA-PV disconnection. After an average follow-up period of 10.4 months, 81.7%, 90.5% and 71.4% of the patients with paroxysmal, persistent and chronic AF, respectively, have been free of AF. In 14.1% of the patients with paroxysmal AF, a greatly reduced frequency and/or duration of the episodes of AF were observed after the ablation. No fatal complications were encountered. The present results suggest that the combination of CPI and supplemental SOPI is efficient and safe for the treatment of AF.

Published in Journal of Arrhythmia

ISSN: 1880-4276 (Print); 1883-2148 (Online)
Publisher: Wiley
Country of publisher: Australia
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://onlinelibrary.wiley.com/journal/18832148

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