[Linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation guided by non-contact 3-dimensional mapping system].
OBJECTIVE
To study the feasibility, safety, effectiveness of linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system.


METHODS
Twenty-eight consecutive patients with drug refractory paroxysmal and persistent AF were included in this study. Real-time 3-dimensional left atrial (LA) and pulmonary veins (PVs) maps were constructed through 3-dimensional mapping system (Ensite NavX) in all patients. Pulmonary vein isolation was performed by encircling the left and right sides of PVs at 1 to 2 cm away from the ostium of PVs. The endpoint of ablation included: All circum PVs ablation lines finished; all PVs were isolated; and non-inducibility of AF was observed.


RESULTS
All 28 patients reached the endpoint of ablation completely. The mean procedure time and fluoroscopy time was (161.3+/-23.2) min and (38.0+/-6.8) min, respectively. During the 6 approximately 17 month follow-up, 20 patients (71%) were free of AF without any antiarrhythmic drugs. Recurrence of AF was found in the other 8 patients (29%): Two were treated with amiodarone and 6 repeated ablation. After the second ablation, 4 were free of AF and 2 recurrence were treated with amiodarone. No complications occurred during the procedure and the follow-up.


CONCLUSIONS
Linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system is effective and safe. But the long-term outcome remains to be investigated.
Zhang
Zhi-hui
ZH
Department of Cardiology,Third Xiangya Hospital,Central South University,Changsha 410013,China.
Cao
Yu
Y
Ou-Yang
Mao
M
Yang
Kan
K
Zhang
Meng-xi
MX
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome