Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy.
BACKGROUND
Most of the ectopic beats initiating paroxysmal atrial fibrillation (PAF) originate from the pulmonary vein (PV). However, only limited data are available on PAF originating from the non-PV areas.


RESULTS
Two hundred forty patients with a total of 358 ectopic foci initiating PAF were included. Sixty-eight (28%) patients had AF initiated by ectopic beats (73 foci, 20%) from the non-PV areas, including the left atrial posterior free wall (28, 38.3%), superior vena cava (27, 37.0%), crista terminalis (10, 3.7%), ligament of Marshall (6, 8.2%), coronary sinus ostium (1, 1.4%), and interatrial septum (1, 1.4%). Catheter ablation eliminated AF with acute success rates of 63%, 96%, 100%, 50%, 100%, and 0% in left atrial posterior free wall, superior vena cava, crista terminalis, ligament of Marshall, coronary sinus ostium, and interatrial septum, respectively. During a follow-up period of 22+/-11 months, 43 patients (63.2%) were free of antiarrhythmic drugs without AF recurrence.


CONCLUSIONS
Ectopic beats initiating PAF can originate from the non-PV areas, and catheter ablation of the non-PV ectopy has a moderate efficacy in treatment of PAF.
Lin
Wei-Shiang
WS
Division of Cardiology, Department of Medicine, National Yang-Ming University, Cardiovascular Research Institute, Taipei/Taichung Veterans General Hospital, Taiwan.
Tai
Ching-Tai
CT
Hsieh
Ming-Hsiung
MH
Tsai
Chin-Feng
CF
Lin
Yung-Kuo
YK
Tsao
Hsuan-Ming
HM
Huang
Jin-Long
JL
Yu
Wen-Chung
WC
Yang
Shih-Ping
SP
Ding
Yu-An
YA
Chang
Mau-Song
MS
Chen
Shih-Ann
SA
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D005117:Cardiac Complexes, Premature / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D018572:Disease-Free Survival; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006331:Heart Diseases / Q000150:complications / Q000503:physiopathology; D006346:Heart Septum / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000503:physiopathology / Q000601:surgery