title: Rapid pulmonary vein isolation combined with autonomic ganglia modification: a randomized study.
abstract: BACKGROUND
  Evidence indicates that the combination of left atrial ganglionated plexi (GP) ablation and pulmonary vein (PV) isolation is beneficial for treatment of paroxysmal atrial fibrillation (AF).
  
  
  OBJECTIVE
  The purpose of this study was to compare GP and PV ablation with PV isolation alone for treatment of paroxysmal AF.
  
  
  METHODS
  Sixty-seven patients with paroxysmal AF were randomized to either PV isolation using a circular catheter suitable for both mapping and ablation (PV group) or anatomic GP modification followed by PV isolation (GP+PV group). Patients were seen at monthly visits, and 48-hour ambulatory ECG recordings were obtained every 3 months for a predefined follow-up period of 12 months. Primary endpoint was freedom from AF or other sustained atrial arrhythmia recurrence 3 to 12 months postablation after one or two procedures, without antiarrhythmic medications.
  
  
  RESULTS
  Recurrence of arrhythmia was documented in 18 (54.5%) patients in the PV group 4.7 ± 1.0 months after ablation, and repeat PV isolation was performed in 7 (21.2%) of these patients 5.1 ± 1.1 months after the first procedure. Recurrence of arrhythmia was documented in 9 (26.5%) patients in the GP+PV group 5.0 ± 1.3 months after ablation, and repeat ablation was performed in 6 (17.6%) of these patients 4.3 ± 0.5 months after the first procedure. At the end of follow-up, 20 (60.6%) patients in the PV group and 29 (85.3%) patients in the GP+PV group remained arrhythmia-free (log rank test, P = .019).
  
  
  CONCLUSIONS
  Addition of anatomic GP modification to PV isolation confers significantly better outcomes than PV isolation alone during a follow-up period of 12 months.
authors.affiliation: Department of Cardiology, Athens Euroclinic, Athens, Greece. dkatritsis@euroclinic.gr
authors.forename: Demosthenes G
authors.initials: DG
authors.lastname: Katritsis
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Giazitzoglou
authors.forename: Theodoros
authors.initials: T
authors.lastname: Zografos
authors.forename: Evgeny
authors.initials: E
authors.lastname: Pokushalov
authors.forename: Sunny S
authors.initials: SS
authors.lastname: Po
authors.forename: A John
authors.initials: AJ
authors.lastname: Camm
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005725:Ganglia, Autonomic / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome