medigraphic.com
ISSN 0016-3813 (Print)

2006, Number 1

<< Back Next >>

Gac Med Mex 2006; 142 (1)

Electrophysiologic study and ablation therapy in idiopatic paroxystic atrial fibrillation.

Márquez MF, Iturralde-Torres P, Colín-Lizalde L, Nava-Townsend S, González-Aceves EN, Hermosillo JAG, Martínez-Ríos MA, Victoria-Romero DR, Cárdenas M

Language: Spanish
References: 15
Page: 43-47
PDF size: 121.52 Kb.


ABSTRACT

Objective: To analyze the results of radiofrequency catheter ablation (RFCA) of the pulmonary veins (PV) in patients with paroxysmal atrial fibrillation (PAF).
Material and methods: We describe 14 patients (38±12 years, interval 8-52; 11 men) with symptomatic PAF, refractory to antiarrhythmic drugs. Special mapping catheters were used and ablation was performed at the ostium/antrum of those veins with abnormal electrical activity (AEA).
Results: AEA in one or more PV was identified in 13 patients (86%); in one patient AEA was also found in the superior vena cava (6.6%). One procedure was complicated by unstable ventricular tachycardia and was not finished. Success was accomplished in 10, in 5 after the first ablation, in 4 after the second, and in one after a third procedure. One patient had pericarditis with a small pericardial effusion that did not require intervention.
Conclusions: RFCA is a useful and relatively safe procedure for the treatment of PAF and the only one with curative potential. The long-term rate of success (with or without antiarrhythmics) in this series was 71%. These results justify catheter ablation in selected patients with symptomatic PAF unresponsive to medical treatment.


REFERENCES

  1. Cárdenas M. "La fibrilación auricular". PAC-EFC-1. Intersistemas, México, 1998.

  2. Haïssaguerre M, Jaïs P, Shah D, Takahashi A, Hocini M, Quiniou G, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Eng J Med 1998;339:659-666.

  3. Jais P, Hocini M, Macle L, Choi KJ, Deisenhofer I, Weerasooriya R, et al. Distinctive electrophysiological properties of pulmonary veins in patients with atrial fibrillation. Circulation 2002;106:2479-2485.

  4. Takahashi Y, Iesaka Y, Takahashi A, Goya M, Kobayashi K, Fujiwara H, Hiraoka M. Reentrant tachycardia in pulmonary veins of patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol 2003;14:927-932.

  5. Perez-Lugones A, McMahon JT, Ratliff NB, Saliba WI, Schweikert RA, Marrouche NF, et al. Evidence of specialized conduction cells in human pulmonary veins of patients with atrial fibrillation. J Cardiovasc Electrophysiol 2003;14:803-89.

  6. Goya M, Ouyang F, Ernst S, Volkmer M, Antz M, Kuck KH:. Electroanatomic mapping and ablation of breakthroughs from the right atrium to the superior vena cava in patients with atrial fibrillation. Circulation 2002;106:1317-1320.

  7. Iturralde P, Medeiros A, Guevara M, Kershenovich S, Varela S, Colín L. Fibrilación auricular focal tratada mediante radiofrecuencia. Arch Inst Cardiol Méx 2000;70:167-172.

  8. Jaïs P, Shah DC, Haïssaguerre M, Hocini M, Garrigue S, Clémenty J. Atrial fibrillation: role of arrhythmogenic foci. J Interv Card Electrophysiol 2000;4:29-37.

  9. Perez-Lugones A, Schvartzman PR, Schweikert R, Tchou PJ, Saliba W, Marrouche NF, et al. Three-dimensional reconstruction of pulmonary veins in patients with atrial fibrillation and controls: morphological characteristics of different veins. Pacing Clin Electrophysiol 2003;26(1Pt1):8-15.

  10. Márquez MF. Ablación con catéter del flutter atrial y de la fibrilación atrial paroxística. Arch Cardiol Mex 2003;73(Supl.1):S88-S92.

  11. Márquez MF, Colín L, Guevara-Valdivia M, Iturralde P, Castañeda R., Villavicencio R, et al. Ablación segmentaria del ostium de la vena pulmonar superior izquierda para eliminar actividad eléctrica anormal generadora de fibrilación atrial paroxística idiopática. Arch Cardiol Mex 2003;73(2):124-128.

  12. Saad EB, Cole CR, Marrouche NF, Dresing TJ, Perez-Lugones A, Saliba WI, et al. Use of intracardiac echocardiography for prediction of chronic pulmonary vein stenosis after ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2002;13:986-989.

  13. Hocini M, Shah DC, Jaïs P, Haïssaguerre M, Peng JT, Yamane T, et al. Concelaed left pulmonary vein potentials unmasked by left atrial stimulation. Pacing Clin Electrophysiol 2000;23(Pt.II):1832-1835.

  14. Macle L, Jais P, Scavee C, Weerasooriya R, Shah DC, Hocini M, et al. Electrophysiologically guided pulmonary vein isolation during sustained atrial fibrillation. J Cardiovasc Electrophysiol 2003;14:255-260.

  15. Haissaguerre M, Jais P, Shah DC, Lavergne T, Hocini M, Takahashi A, et al. Catheter ablation of paroxysmal atrial fibrillation: results in 234. En: Huang SKS, Wilber




2020     |     www.medigraphic.com