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Efficacy of Radiofrequency Catheter Ablation on Non-Pulmonary Vein Originated Atrial Fibrillation
作者:夏云龙[1] 
单位:大连医科大学附属第一医院[1]  
文章号:W013635  
2006/8/16 19:11:29    
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    Background: Pulmonary vein (PV) has been demonstrated to be important for initiation of Paroxysmal Atrial fibrillation (PAF), and PV isolation has become a major strategy for treatment of PAF. Non-PV foci also play essential roles in some PAF patients. However, only limited data could be found for evaluation of non-PV foci ablation.

    Methods and results: Two hundred and fifty six patients (62 female, mean age 53±12 ys.) with PAF were included. During the electrophysiologic study, twenty-seven patients (10.5%) were found with ectopic foci in non-PV areas (Group NPV), including the superior vena cava (16, 59.3%), left atrial posterial wall (4, 14.8%), crista terminalis (2, 7.4%), coronary sinus (2, 7.4%), fossa ovalis (1, 3.7%), left appendage (1, 3.7%), left atrial anterior wall (1, 3.7%). The rest patients were defined as Group PV. In Group NPV, all the non-PV foci were successfully eliminated during the first procedure. Second procedure was needed in 4 cases (14.8%), with 3 foci from SVC and one from left atrial posterior wall, whereas 56 cases received second procedure in all these patients (20.3%). Six ones received the third procedure, but no one is from Group NPV. No one in Group NPV got complication. During a follow-up period of 22±14 months, the 25 patients from Group NPV were free of PAF recurrence (92.5%), as compared to 185 without PAF recurrence in Group PV (72.7%) after follow up for 26±15 months.

     Conclusions: Identification and elimination of non-PV foci are important for treatment of PAF in a subset of patients. Ablation in patients with non-PV foci clearly found could lead to a higher successful rate compare to those with PV isolation being routinely performed.

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作者简介
夏云龙
单位:大连医科大学附属第一医院
简介:  博士,教授,博士生导师;教育部长江学者特聘教授。美国心律学学会委员(FHRS);欧洲心脏病学会委
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