Abstract
The aim of this study was to categorize arrhythmia mechanisms and to summarize ablation strategies in patients with persistent pulmonary vein isolation (PVI) at the time of redo procedures. Persistent PVI is more frequently seen in patients undergoing redo procedures for recurrent atrial arrhythmias after catheter ablation for atrial fibrillation (AF). Consecutive patients who underwent their first AF ablation procedures at Brigham and Women's Hospital were screened and included if they had persistent isolation of all pulmonary veins at the time of redo procedures. Of 300 consecutive patients undergoing first AF ablation procedures, redo procedures were performed in 63 (21%), and 26 patients (9%) had persistent PVI. Of those, 11 had recurred with AF and 15 with organized atrial tachycardia (AT). During the index procedure, linear ablation was performed in 46% of patients with recurrent AF and 93% with recurrent organized AT (p = 0.020). At the time of last follow-up, 2 of 10 patients (20%) in the AF group and 10 of 15 patients (67%) in AT group were in sinus rhythm, without class I or III antiarrhythmic drugs (p = 0.022). Patients with recurrence of atrial arrhythmia despite persistent PVI frequently present with organized AT. ...Continue Reading
References
Jun 3, 2004·Journal of the American College of Cardiology·Koonlawee NademaneeTachapong Ngarmukos
Nov 3, 2004·Circulation·Pierre JaïsMichel Haïssaguerre
Dec 30, 2004·Circulation·Feifan OuyangKarl-Heinz Kuck
Dec 14, 2005·Circulation·Mélèze HociniMichel Haïssaguerre
Aug 23, 2006·American Heart Journal·Brian NilssonJesper H Svendsen
Oct 30, 2007·Journal of the American College of Cardiology·Sanders ChaeAman Chugh
Mar 11, 2009·Pacing and Clinical Electrophysiology : PACE·George D VeenhuyzenMichel Haïssaguerre
Feb 27, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Daniel StevenGregory F Michaud
Jun 15, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Kiyoshi OtomoYoshito Iesaka
May 25, 2011·Circulation·Gregory F Michaud, Roy John
Aug 23, 2011·Circulation. Arrhythmia and Electrophysiology·Sonia AmmarIsabel Deisenhofer
Mar 6, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hugh CalkinsUNKNOWN Heart Rhythm Society Task Force on Catheter and Surgical Ablation of Atrial Fibrillation
May 7, 2013·Journal of the American College of Cardiology·Daniel StevenGregory F Michaud
Oct 8, 2013·Circulation. Arrhythmia and Electrophysiology·Agustín BortonePhilippe Rioux
Nov 2, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Tobias ReichlinGregory F Michaud
May 9, 2014·Circulation·Chirag R BarbhaiyaGregory F Michaud
Sep 10, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Chirag R BarbhaiyaGregory F Michaud
May 7, 2015·The New England Journal of Medicine·Atul VermaUNKNOWN STAR AF II Investigators
Dec 25, 2015·Journal of the American College of Cardiology·Julia VoglerDaniel Steven