title: Impact of patent foramen ovale on left atrial linear lesions in the context of atrial fibrillation ablation.
abstract: BACKGROUND
  We investigated the impact of the mode of left atrial (LA) access via patent foramen ovale (PFO) versus transseptal (TS) puncture on LA linear lesions during atrial fibrillation (AF) ablation.
  
  
  RESULTS
  We investigated 139 (PFO: 25) consecutive patients who underwent mitral isthmus (MI) and/or LA roof linear ablation. Technical endpoint was completeness of linear lesions and duration of radiofrequency (RF) application. During the initial procedure, complete MI and LA roof blocks were created in 13 of 19 (68%) and 14 of 17 (82%) patients in the PFO group, and in 57 of 94 (61%) and 54 of 70 (74%) patients in the TS group, respectively (P = NS). There was no significant difference in RF durations at MI (11.1 ± 8.9 and 15.1 ± 7.6 minutes, P = 0.11), and LA roof (10.1 ± 3.5 and 8.3 ± 5.0 minutes, P = 0.21) between the 2 groups. Among 28 patients who underwent repeat linear ablation, complete MI and LA roof blocks were created in 3 of 4 (75%) and 0 of 1 (0%) patients in the PFO group, and in 16 of 21 (76%) and 7 of 10 (70%) patients in the TS group, respectively (P = NS). There was no significant difference in RF durations at MI (15.3 ± 8.3 and 19.5 ± 18.3 minutes, P = 0.71), and LA roof (19.0 and 10.3 ± 5.4 minutes, P = 0.19) between the 2 groups. Clinical outcomes at 12 months were also similar.
  
  
  CONCLUSIONS
  There were no significant differences in the procedural success rates, durations of RF application, 12-month clinical outcomes, and complication rates of LA linear ablation between the PFO and TS groups. Accessing the LA via a PFO is not an unfavorable approach toward LA linear ablation.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France. mshinsuke@k3.dion.ne.jp
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Shah
authors.forename: Isabelle
authors.initials: I
authors.lastname: Nault
authors.forename: Matthew
authors.initials: M
authors.lastname: Wright
authors.forename: Amir S
authors.initials: AS
authors.lastname: Jadidi
authors.forename: Andrei
authors.initials: A
authors.lastname: Forclaz
authors.forename: Xingpeng
authors.initials: X
authors.lastname: Liu
authors.forename: Nick
authors.initials: N
authors.lastname: Linton
authors.forename: Olivier
authors.initials: O
authors.lastname: Xhaët
authors.forename: Lena
authors.initials: L
authors.lastname: Rivard
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000503:physiopathology / Q000601:surgery*; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged