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Ostial PV Isolation:: Is There a Role for Three‐Dimensional Mapping? by SABINE ERNST; MATTHIAS ANTZ; FEIFAN OUYANG; THOMAS VOGTMANN; MASAHIKO GOYA; DIETMAR BÄNSCH; ANSELM SCHAUMANN; KARL‐HEINZ KUCK is a Medicine article available to read on EtoBox.

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__Pulmonary vein (PV) isolation by elimination of spike potentials has been reported to cure drug refractory atrial fibrillation. Because of the heterogenous morphology of the PVs, sequential electroanatomic reconstruction of the PVs was performed in 39 patients (group A), who underwent subsequent PV isolation by interruption of all conductive myocardial fibers by distinct RF current applications using a “lasso” approach. In group B (157 patients), only biplane two‐dimensional fluoroscopy was performed to guide the diagnostic and the ablation catheters. After reprocedures (in 7% of patients in group A and 22% of group B), which depicted a recurrence of a spike potential inside or at the ostium of >1 previously isolated PV in all restudied patients, stable sinus rhythm was documented in 69% of patients in group A and 60% of patients in group B. Reasons for the relapse of the previously eliminated spike potentials include a temporary ablation effect and a too distal interruption of the conducting myocardial fiber. Detailed knowledge of the individual three‐dimensional morphology enhanced the clinical success rate of PV isolation but is time‐consuming using CARTO__ __(8.0 ± 1.7 vs 5.

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Author

SABINE ERNST; MATTHIAS ANTZ; FEIFAN OUYANG; THOMAS VOGTMANN; MASAHIKO GOYA; DIETMAR BÄNSCH; ANSELM SCHAUMANN; KARL‐HEINZ KUCK

Publisher

John Wiley and Sons; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Wiley (ISSN 0147-8389)

Published

2003

Language

EN

Field

Medicine (Health Sciences)