title: Segmental pulmonary vein antrum isolation using the "large-size" lasso catheter in patients with atrial fibrillation.
abstract: BACKGROUND
  The limited efficacy and complications of segmental ostial pulmonary vein isolation (PVI) for treating atrial fibrillation (AF) have been discussed so, in the present study the feasibility and efficiency of performing segmental pulmonary vein (PV) antrum isolation to treat AF were assessed.
  
  
  RESULTS
  A total of 187 patients with drug-refractory AF (paroxysmal 120, persistent 67) underwent segmental PVI guided by circumferential 20-electrode catheters (Lasso). Radiofrequency (RF) current was delivered either at the ostium using a regular Lasso (15-20 mm in diameter, 70 patients: Group 1) or at the antrum using a larger Lasso (25-30 mm in diameter, 117 patients: Group 2). A significantly wider region had to be ablated, with a longer RF application time, to isolate all 4 PVs in Group 2 patients than in Group 1 patients. Although the rate of recurrence of AF after the initial session was equal in both groups, a significantly greater number of patients were free from AF after a mean of 1.4 procedures in Group 2 than in Group 1 (93% vs 76% for paroxysmal AF, 78% vs 48% for persistent AF).
  
  
  CONCLUSIONS
  Segmental antral PVI using large-sized Lasso catheters was found to be more effective and safer than ostial PVI for the treatment of AF.
authors: Department of Cardiology, Jikei University School of Medicine, Nishi-shinbashi, Minato-ku, Tokyo, Japan. yamanet1@aol.com
authors: Teiichi
authors: T
authors: Yamane
authors: Taro
authors: T
authors: Date
authors: Yasuko
authors: Y
authors: Kanzaki
authors: Keiichi
authors: K
authors: Inada
authors: Seiichiro
authors: S
authors: Matsuo
authors: Kenri
authors: K
authors: Shibayama
authors: Satoru
authors: S
authors: Miyanaga
authors: Hidekazu
authors: H
authors: Miyazaki
authors: Ken-ichi
authors: K
authors: Sugimoto
authors: Seibu
authors: S
authors: Mochizuki
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods*; D002404:Catheterization; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome