title: The linear ablation of atrial fibrillation in the right atrium: can the isthmus ablation improve its efficacy?
abstract: OBJECTIVE
  The aims of this study were to compare the efficacy of a 2- versus a 3 RF lesions ablation procedure in the RA in patients with paroxysmal AF, and to map right atrial activation during AF.
  
  
  BACKGROUND
  RF catheter-mediated ablation lines mimicking the Maze operation have been proposed as a novel curative approach for AF. The relationship between this type of ablation and right atrial mapping has not been extensively studied.
  
  
  METHODS
  Twenty-four patients with recurrent, drug-refractory, paroxysmal AF underwent an extensive mapping of the RA before attempting linear lesion RF ablation. Patients were divided into two groups: 15 patients received two linear lesions (Group 1), 9 patients three linear lesions (Group 2).
  
  
  RESULTS
  One-month success rate AF did not recur in 40% of Group 1 patients (6/15) and in 66% (6/9) of Group 2 patients. 27% of patients in Group 1 and 11% of patients in Group 2 had recurrences controlled by drugs. No benefit in 33% of Group 1 patients and 22% of Group 2. Long-term follow-up In the absence of any drug treatment, no AF recurrences were observed in 26% of Group 1 patients (FU: 23 to 47 months) and 55% of Group 2 (FU: 14 to 23 months). No complications were reported.
  
  
  CONCLUSIONS
  Right atrial linear ablation is safe and may be proposed for AF treatment in selected patients.
authors.affiliation: Divisione di Cardiologia, Policlinico Multimedica, Sesto S.Giovanni (MI), Terni, Italy. montenero@hotmail.com
authors.forename: Annibale Sandro
authors.initials: AS
authors.lastname: Montenero
authors.forename: Michèle
authors.initials: M
authors.lastname: Adam
authors.forename: Pasquale
authors.initials: P
authors.lastname: Franciosa
authors.forename: Francesco
authors.initials: F
authors.lastname: Zumbo
authors.forename: Andrea
authors.initials: A
authors.lastname: Antonelli
authors.forename: Daniele
authors.initials: D
authors.lastname: Mangiameli
authors.forename: Pietro
authors.initials: P
authors.lastname: Bartolini
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Barbaro
authors.forename: Fulvio
authors.initials: F
authors.lastname: Bellocci
authors.forename: Paolo
authors.initials: P
authors.lastname: Zecchi
authors.forename: Attilio
authors.initials: A
authors.lastname: Maseri
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D015331:Cohort Studies; D004562:Electrocardiography; D004566:Electrodes; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome