Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation

Rong Bai, Luigi Di Biase, Prasant Mohanty, Chintan Trivedi, Antonio Dello Russo, Sakis Themistoclakis, Michela Casella, Pietro Santarelli, Gaetano Fassini, Pasquale Santangeli, Sanghamitra Mohanty, Antonio Rossillo, Gemma Pelargonio, Rodney Horton, Javier Sanchez, Joseph Gallinghouse, J. David Burkhardt, Chang Sheng Ma, Claudio Tondo, Andrea Natale

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background It is unclear whether isolation of the left atrial posterior wall (LAPW) offers additional benefits over pulmonary vein antrum isolation (PVAI) alone in patients with persistent atrial fibrillation (AF). Objective We sought to determine the impact of PVAI and LAPW isolation (PVAI+LAPW) versus PVAI alone on the outcome of ablation of persistent AF. Methods During the first procedure, PVAI was performed in 20 patients (group 1), whereas in 32 patients (group 2), PVAI was extended to the left atrial (LA) septum and coronary sinus (CS), and isolation of the LAPW was targeted (ePVAI+LAPW). Isolation of the superior vena cava was achieved in both groups. All patients, regardless of arrhythmia recurrence, underwent a second procedure 3 months after the first procedure. In patients with reconnection of pulmonary veins or LAPW, reisolation was performed, and a third procedure was performed 3 months later to verify isolation. Patients entered follow-up only after PVAI (group 1) or PVAI+LAPW (group 2) isolation was proven. Results At the 1-, 2-, and 3-year follow-up examinations, the rates of freedom from atrial tachyarrhythmia without use of an antiarrhythmic drug were 20%, 15%, and 10% in group 1 and 65%, 50%, and 40% in group 2, respectively (log-rank P

Original languageEnglish (US)
Pages (from-to)132-140
Number of pages9
JournalHeart Rhythm
Volume13
Issue number1
DOIs
StatePublished - Jan 1 2016

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Patient Isolation
Pulmonary Veins
Atrial Fibrillation
Atrial Septum
Superior Vena Cava
Coronary Sinus
Anti-Arrhythmia Agents
Tachycardia
Cardiac Arrhythmias
Recurrence

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Left atrial posterior wall
  • Pulmonary vein antrum isolation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation. / Bai, Rong; Di Biase, Luigi; Mohanty, Prasant; Trivedi, Chintan; Dello Russo, Antonio; Themistoclakis, Sakis; Casella, Michela; Santarelli, Pietro; Fassini, Gaetano; Santangeli, Pasquale; Mohanty, Sanghamitra; Rossillo, Antonio; Pelargonio, Gemma; Horton, Rodney; Sanchez, Javier; Gallinghouse, Joseph; Burkhardt, J. David; Ma, Chang Sheng; Tondo, Claudio; Natale, Andrea.

In: Heart Rhythm, Vol. 13, No. 1, 01.01.2016, p. 132-140.

Research output: Contribution to journalArticle

Bai, R, Di Biase, L, Mohanty, P, Trivedi, C, Dello Russo, A, Themistoclakis, S, Casella, M, Santarelli, P, Fassini, G, Santangeli, P, Mohanty, S, Rossillo, A, Pelargonio, G, Horton, R, Sanchez, J, Gallinghouse, J, Burkhardt, JD, Ma, CS, Tondo, C & Natale, A 2016, 'Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation', Heart Rhythm, vol. 13, no. 1, pp. 132-140. https://doi.org/10.1016/j.hrthm.2015.08.019
Bai, Rong ; Di Biase, Luigi ; Mohanty, Prasant ; Trivedi, Chintan ; Dello Russo, Antonio ; Themistoclakis, Sakis ; Casella, Michela ; Santarelli, Pietro ; Fassini, Gaetano ; Santangeli, Pasquale ; Mohanty, Sanghamitra ; Rossillo, Antonio ; Pelargonio, Gemma ; Horton, Rodney ; Sanchez, Javier ; Gallinghouse, Joseph ; Burkhardt, J. David ; Ma, Chang Sheng ; Tondo, Claudio ; Natale, Andrea. / Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation. In: Heart Rhythm. 2016 ; Vol. 13, No. 1. pp. 132-140.
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abstract = "Background It is unclear whether isolation of the left atrial posterior wall (LAPW) offers additional benefits over pulmonary vein antrum isolation (PVAI) alone in patients with persistent atrial fibrillation (AF). Objective We sought to determine the impact of PVAI and LAPW isolation (PVAI+LAPW) versus PVAI alone on the outcome of ablation of persistent AF. Methods During the first procedure, PVAI was performed in 20 patients (group 1), whereas in 32 patients (group 2), PVAI was extended to the left atrial (LA) septum and coronary sinus (CS), and isolation of the LAPW was targeted (ePVAI+LAPW). Isolation of the superior vena cava was achieved in both groups. All patients, regardless of arrhythmia recurrence, underwent a second procedure 3 months after the first procedure. In patients with reconnection of pulmonary veins or LAPW, reisolation was performed, and a third procedure was performed 3 months later to verify isolation. Patients entered follow-up only after PVAI (group 1) or PVAI+LAPW (group 2) isolation was proven. Results At the 1-, 2-, and 3-year follow-up examinations, the rates of freedom from atrial tachyarrhythmia without use of an antiarrhythmic drug were 20{\%}, 15{\%}, and 10{\%} in group 1 and 65{\%}, 50{\%}, and 40{\%} in group 2, respectively (log-rank P",
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T1 - Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation

AU - Bai, Rong

AU - Di Biase, Luigi

AU - Mohanty, Prasant

AU - Trivedi, Chintan

AU - Dello Russo, Antonio

AU - Themistoclakis, Sakis

AU - Casella, Michela

AU - Santarelli, Pietro

AU - Fassini, Gaetano

AU - Santangeli, Pasquale

AU - Mohanty, Sanghamitra

AU - Rossillo, Antonio

AU - Pelargonio, Gemma

AU - Horton, Rodney

AU - Sanchez, Javier

AU - Gallinghouse, Joseph

AU - Burkhardt, J. David

AU - Ma, Chang Sheng

AU - Tondo, Claudio

AU - Natale, Andrea

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background It is unclear whether isolation of the left atrial posterior wall (LAPW) offers additional benefits over pulmonary vein antrum isolation (PVAI) alone in patients with persistent atrial fibrillation (AF). Objective We sought to determine the impact of PVAI and LAPW isolation (PVAI+LAPW) versus PVAI alone on the outcome of ablation of persistent AF. Methods During the first procedure, PVAI was performed in 20 patients (group 1), whereas in 32 patients (group 2), PVAI was extended to the left atrial (LA) septum and coronary sinus (CS), and isolation of the LAPW was targeted (ePVAI+LAPW). Isolation of the superior vena cava was achieved in both groups. All patients, regardless of arrhythmia recurrence, underwent a second procedure 3 months after the first procedure. In patients with reconnection of pulmonary veins or LAPW, reisolation was performed, and a third procedure was performed 3 months later to verify isolation. Patients entered follow-up only after PVAI (group 1) or PVAI+LAPW (group 2) isolation was proven. Results At the 1-, 2-, and 3-year follow-up examinations, the rates of freedom from atrial tachyarrhythmia without use of an antiarrhythmic drug were 20%, 15%, and 10% in group 1 and 65%, 50%, and 40% in group 2, respectively (log-rank P

AB - Background It is unclear whether isolation of the left atrial posterior wall (LAPW) offers additional benefits over pulmonary vein antrum isolation (PVAI) alone in patients with persistent atrial fibrillation (AF). Objective We sought to determine the impact of PVAI and LAPW isolation (PVAI+LAPW) versus PVAI alone on the outcome of ablation of persistent AF. Methods During the first procedure, PVAI was performed in 20 patients (group 1), whereas in 32 patients (group 2), PVAI was extended to the left atrial (LA) septum and coronary sinus (CS), and isolation of the LAPW was targeted (ePVAI+LAPW). Isolation of the superior vena cava was achieved in both groups. All patients, regardless of arrhythmia recurrence, underwent a second procedure 3 months after the first procedure. In patients with reconnection of pulmonary veins or LAPW, reisolation was performed, and a third procedure was performed 3 months later to verify isolation. Patients entered follow-up only after PVAI (group 1) or PVAI+LAPW (group 2) isolation was proven. Results At the 1-, 2-, and 3-year follow-up examinations, the rates of freedom from atrial tachyarrhythmia without use of an antiarrhythmic drug were 20%, 15%, and 10% in group 1 and 65%, 50%, and 40% in group 2, respectively (log-rank P

KW - Atrial fibrillation

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KW - Pulmonary vein antrum isolation

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