The linear ablation of atrial fibrillation in the right atrium: can the isthmus ablation improve its efficacy?
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.
Montenero
Annibale Sandro
AS
Divisione di Cardiologia, Policlinico Multimedica, Sesto S.Giovanni (MI), Terni, Italy. montenero@hotmail.com
Adam
Michèle
M
Franciosa
Pasquale
P
Zumbo
Francesco
F
Antonelli
Andrea
A
Mangiameli
Daniele
D
Bartolini
Pietro
P
Barbaro
Vincenzo
V
Bellocci
Fulvio
F
Zecchi
Paolo
P
Maseri
Attilio
A
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