title: Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy.
abstract: 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.
authors.affiliation: Division of Cardiology, Department of Medicine, National Yang-Ming University, Cardiovascular Research Institute, Taipei/Taichung Veterans General Hospital, Taiwan.
authors.forename: Wei-Shiang
authors.initials: WS
authors.lastname: Lin
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Tai
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Chin-Feng
authors.initials: CF
authors.lastname: Tsai
authors.forename: Yung-Kuo
authors.initials: YK
authors.lastname: Lin
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Jin-Long
authors.initials: JL
authors.lastname: Huang
authors.forename: Wen-Chung
authors.initials: WC
authors.lastname: Yu
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Yang
authors.forename: Yu-An
authors.initials: YA
authors.lastname: Ding
authors.forename: Mau-Song
authors.initials: MS
authors.lastname: Chang
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: 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