Non-pulmonary vein epicardial foci of atrial fibrillation identified in the left atrium after pulmonary vein isolation.

Non-pulmonary vein epicardial foci of atrial fibrillation identified in the left atrium after pulmonary vein isolation. Research Abstract Details 

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Non-pulmonary vein epicardial foci of atrial fibrillation identified in the left atrium after pulmonary vein isolation. Abstract Text:

Takumi Yamada,Yoshimasa Murakami,Taro Okada,Naoki Yoshida,Yuichi Ninomiya,Junji Toyama,Yukihiko Yoshida,Naoya Tsuboi,Yasuya Inden,Makoto Hirai,Toyoaki Murohara,Hugh T McElderry,Andrew E Epstein,Vance J Plumb,G Neal Kay,Takumi Yamada,Yoshimasa Murakami,Taro Okada,Naoki Yoshida,Yuichi Ninomiya,Junji Toyama,Yukihiko Yoshida,Naoya Tsuboi,Yasuya Inden,Makoto Hirai,Toyoaki Murohara,Hugh T McElderry,Andrew E Epstein,Vance J Plumb,G Neal Kay,

BACKGROUND: Pulmonary vein (PV) isolation (PVI) has been demonstrated to be an effective technique for curing atrial fibrillation (AF). AF foci that cannot be isolated by PVI (non-PV foci) can become the cause of AF recurrence. The purpose of this study was to investigate the characteristics of non-PV AF foci. METHODS AND RESULTS: Two hundred consecutive patients with symptomatic AF underwent electrophysiologic studies. In all patients, successful ostial or antral PVI was achieved with a multielectrode basket catheter (MBC). In 45 patients, spontaneous AF was induced even after PVI. In 23 of those patients, 30 AF foci were found in the left atrium (LA) (12 in the PV antrum, and 18 in the LA wall). Twenty-six of those foci were eliminated by focal ablation guided by an MBC. Five of those foci (four in the PV antrum and one in the LA posterior wall) were speculated to be located epicardially because a small potential preceding the LA potential was recorded from the MBC electrodes during AF initiation at the successful ablation site where single large potentials were recorded during sinus rhythm and a longer duration of radiofrequency energy delivery was needed to eliminate them. CONCLUSIONS: MBC mapping with induction of spontaneous AF may be useful for identifying non-PV AF foci in the LA after PVI. In some of those non-PV foci, mainly around the PVI lesions, a few electrophysiologic findings suggesting an epicardial location were observed. This may be a rationale for the efficacy of extensive PV ablation.

Non-pulmonary vein epicardial foci of atrial fibrillation identified in the left atrium after pulmonary vein isolation. Publishing Authors By Initials

T Yamada,Y Murakami,T Okada,N Yoshida,Y Ninomiya,J Toyama,Y Yoshida,N Tsuboi,Y Inden,M Hirai,T Murohara,HT McElderry,AE Epstein,VJ Plumb,GN Kay,T Yamada,Y Murakami,T Okada,N Yoshida,Y Ninomiya,J Toyama,Y Yoshida,N Tsuboi,Y Inden,M Hirai,T Murohara,HT McElderry,AE Epstein,VJ Plumb,GN Kay,

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Non-pulmonary vein epicardial foci of atrial fibrillation identified in the left atrium after pulmonary vein isolation. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Pacing and clinical electrophysiology : PACE

VOLUME: 30

Page Numbers: 1323-30

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ISSN: 0147-8389

DAY: 2

MONTH: Nov

YEAR: 2007

Non-pulmonary vein epicardial foci of atrial fibrillation identified in the left atrium after pulmonary vein isolation. Information

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LANGUAGE: eng

NlmUniqueID: 7803944

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AFFILIATION: Division of Cardiovascular Diseases, University of Alabama at Birmingham, 1670 University Boulevard, Birmingham, AL 35294, USA. takumi-y@fb4.so-net.ne.jp

Country: United States

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MEDLINETA: Pacing Clin Electrophysiol

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