Clinical characteristics and long-term outcome of non-pulmonary vein foci ablation in patients with paroxysmal atrial fibrillation
10.3760/cma.j.issn.0253-3758.2013.11.006
- VernacularTitle:阵发性心房颤动非肺静脉触发灶的临床特征及长期随访
- Keywords:
Atrial fibrillation;
Aatheter ablation
- From:
Chinese Journal of Cardiology
2013;41(11):922-926
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical characteristics and long-term results of nonpulmonary veins (PV) trigger ablation in patients with paroxysmal atrial fibrillation (AF).Methods Eighty-six patients [48 men,mean age (52.3 ± 10.2) years] were included in the study.Circumferential pulmonary vein antrum isolation guided by a 3-D mapping system was performed.Aggressive high right atrium programmed stimulation and burst pacing were made before and after isoproterenol infusion.Additional ablation was performed if other trigger foci were found or other sustained tachycardias could be induced.Results PV triggers were observed in 59 patients (group Ⅰ),and non-PV triggers were observed in 27 patients (group Ⅱ),12 non-PV triggers were identified during the first procedure.Among them,one was located in the roof of left atrium,11 were originated from superior vena cava.After a mean follow-up of [37.1 ± 10.4 (range 15-60)] months,the AF recurrence rate was significantly higher in the Group Ⅱ than in the Group Ⅰ (55.5％ vs.20.3％,P =0.001).The number of performed ablation was also significantly in group Ⅱ than in group Ⅰ higher difference (1.7 ±0.8 vs.1.1 ±0.4,P ＜0.001).In the group Ⅱ,15/15 (100％) patients had a repeated ablation procedure for AF recurrence,and 15 patients had new non-PV foci after isoproterenol infusion which were originated from the superior vena cava (n =11) and coronary sinus (n =2),respectively.After the second ablation procedure,AF recurrence was observed in three patients,two patients accepted third procedure,the non-PV triggers were located in lefi atrial septum and coronary sinus,and one patient accepted fourth procedure,the non-PV foci was located in left posterior wall.Conclusions Non-PV foci may occur at any age and the main area is located in the super vena cava,Non-PV serves as a major cause of AF recurrence after successful PVAI.
