Segmental pulmonary vein antrum isolation using the "large-size" lasso catheter in patients with atrial fibrillation.
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.
Yamane
Teiichi
T
Department of Cardiology, Jikei University School of Medicine, Nishi-shinbashi, Minato-ku, Tokyo, Japan. yamanet1@aol.com
Date
Taro
T
Kanzaki
Yasuko
Y
Inada
Keiichi
K
Matsuo
Seiichiro
S
Shibayama
Kenri
K
Miyanaga
Satoru
S
Miyazaki
Hidekazu
H
Sugimoto
Ken-ichi
K
Mochizuki
Seibu
S
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