Catheter ablation of left atrial ganglionated plexi for atrial fibrillation.
Radiofrequency ablation of pulmonary vein ostia does not provide complete and long-term elimination of atrial fibrillation. Combining this procedure with local radiofrequency application on sites with strong vagal reflexes results in partial parasympathetic denervation and increases the antiarrhythmic effect. A novel catheter-ablation technique to modify ganglionated plexi in the left atrium was assessed in 58 patients (mean age, 52.1 +/- 1.9 years, 67% male) with drug-refractory atrial fibrillation, which was chronic in 21 (36%; mean duration, 14.3 +/- 2.9 months; range, 5-39 months). The mean left atrial volume was 93.1 +/- 6.1 mL. The patients underwent ablation of 4 areas of ganglionated plexi in the left atrium, with no circumferential ablation of the pulmonary veins; atrial fibrillation ceased immediately in 94.1% of them. Transient vagal bradycardia was seen in 93% of patients. For 7.2 +/- 0.4 months after the procedure, 86.2% of them were free from arrhythmias, and no antiarrhythmic drugs were administered. Ganglionated plexi ablation is an efficient treatment for atrial fibrillation.
State Research Institute of Circulation Pathology, Novosibirsk, Russia. pokush@mail.ru
Evgueny
E
Pokushalov
Alex
A
Turov
Pavel
P
Shugayev
Sergey
S
Artyomenko
Alex
A
Romanov
Natalya
N
Shirokova
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005728:Ganglia, Sympathetic; D006325:Heart Atria / Q000294:innervation; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome