title: Complete pulmonary vein isolation guided by three-dimensional electroanatomical mapping for the treatment of paroxysmal atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy.
abstract: OBJECTIVE
  Evaluation of the clinical outcome of patients with hypertrophic obstructive cardiomyopathy (HOCM) and paroxysmal atrial fibrillation (AF) treated with complete pulmonary vein (PV) isolation guided by three-dimensional (3-D) electroanatomical (EA) mapping.
  
  
  METHODS
  Circumferential radiofrequency (RF) ablation and continuous circular lesions (CCLs) around the left and right-sided PVs were performed in 4 highly symptomatic patients (2 males; age 57.5 +/- 8.3 years) with HOCM and anti-arrhythmic drug (AAD) refractory paroxysmal AF. Ablation was guided by 3-D EA mapping combined with conventional circumferential PV mapping. The endpoints of the ablation were defined as: (1) absence of all PV spikes documented with the two Lasso catheters within the ipsilateral PVs; and (2) no recurrence of the PV spikes within all PVs following intravenous administration of adenosine.
  
  
  RESULTS
  The ablation endpoints were achieved in all patients. A repeat ablation was performed in one patient due to repetitive atrial tachycardia, 1 month after the initial procedure. During a follow-up of 5.8 +/- 2.7 months, all patients are free of AF recurrence. Short episodes of symptomatic AT were documented after the repeat procedure, and were well controlled with oral amiodarone in the patient. No procedure-related complications were observed.
  
  
  CONCLUSIONS
  The present study demonstrates that complete isolation of ipsilateral PVs guided by 3-D EA mapping is potentially effective for the treatment of highly symptomatic, drug refractory paroxysmal AF in patients with HOCM.
authors.affiliation: II. Med. Abteilung, Allgemeines Krankenhaus St. Georg, Hamburg, Germany.
authors.forename: Xingpeng
authors.initials: X
authors.lastname: Liu
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
authors.forename: Hercules
authors.initials: H
authors.lastname: Mavrakis
authors.forename: Changsheng
authors.initials: C
authors.lastname: Ma
authors.forename: Jianzeng
authors.initials: J
authors.lastname: Dong
authors.forename: Sabine
authors.initials: S
authors.lastname: Ernst
authors.forename: Dietmar
authors.initials: D
authors.lastname: Bänsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Antz
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000503:physiopathology; D017115:Catheter Ablation; D017023:Coronary Angiography; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology*; D015641:Radiography, Interventional; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome