Inducibility of atrial tachyarrhythmias after circumferential pulmonary vein isolation in patients with paroxysmal atrial fibrillation: clinical predictor and outcome during follow-up.
OBJECTIVE
We investigated the presence and clinical outcome of inducibility of atrial tachyarrhythmias after circumferential pulmonary vein isolation (CPVI) in patients with paroxysmal atrial fibrillation (PAF).


RESULTS
Sixty patients with symptomatic PAF underwent CPVI guided by 3D mapping and double Lasso technique. After achievement of CPVI, the induction was performed. The left atrium (LA) volume and the isolated LA area around the right and left-sided pulmonary veins were measured by the 3D mapping system. Sustained atrial tachyarrhythmias (>10 min) were induced after CPVI in 17 of 60 patients (28%). Patients with inducible atrial tachyarrhythmias had significantly smaller isolated areas when compared with the group with non-inducible tachyarrhythmias (16.7 +/- 2.3 vs. 18.8 +/- 2.9%, P < 0.05). After the initial procedure, recurrence occurred in 18 of 43 (42%) patients in the non-inducible group and in 7 of 17 (41%) in the inducible group during follow-up. A repeat procedure was performed in all 25 patients with recurrence. Five patients had a recurrence after the repeat procedure during 20.8 +/- 7.5 months, and there was no difference between the two groups.


CONCLUSIONS
Inducibility of atrial tachyarrhythmias is associated with proportionally smaller isolated area and does not predict the clinical efficacy of CPVI in patients with PAF.
Satomi
Kazuhiro
K
II Med Abteilung, Asklepios Klinik St Georg, Lohmühlenstrasse 5, 20099 Hamburg, Germany.
Tilz
Roland
R
Takatsuki
Seiji
S
Chun
Julian
J
Schmidt
Boris
B
Bänsch
Dietmar
D
Antz
Matthias
M
Zerm
Thomas
T
Metzner
Andreas
A
Köktürk
Bülent
B
Ernst
Sabine
S
Greten
Heiner
H
Kuck
Karl-Heinz
KH
Ouyang
Feifan
F
D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D011667:Pulmonary Veins / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome