title: Pulmonary vein antrum isolation of pre-excited atrial fibrillation.
abstract: BACKGROUND
  Pulmonary vein antrum isolation (PVAI) of pre-excited atrial fibrillation (AF) is controversial. This study aimed to observe the therapeutic effects of PVAI on pre-excited AF.
  
  
  METHODS
  Twenty-nine patients with pre-excited AF were prospectively divided into a PVAI group (group I, 19 cases) and a control group (group II, 10 cases). To each case in group I, PVAI was performed, and then electroanatomical mapping of accessory pathways (AP) and ablation were constructed on a three-dimensional (3D) map of the valve annulus. Only AP ablation was performed in each case of group II.
  
  
  RESULTS
  Of the 29 cases, three were found to have dual APs, two had intermittent APs, and the remaining 24 had single APs. All APs were successfully ablated after the procedure. There were no significant statistical differences in the AP procedure duration ((77.4 ± 21.3) minutes vs. (85.3 ± 13.1) minutes), the AP ablation time ((204 ± 34) seconds vs. (223 ± 62) seconds) and the AP X-ray exposure time ((18.6 ± 4.4) minutes vs. (19.1 ± 4.5) minutes) respectively between groups I and II. As compared with the control group (5 of 10 cases, 50%), the PVAI group had a significantly lower AF recurrence rate (2 of 19 cases, 11%; P < 0.05) during follow-up of (20.5 ± 10.0) months. All seven patients who recurred were successfully abolished by a second ablation.
  
  
  CONCLUSIONS
  In patients with pre-excited AF, PVAI is an effective therapeutic approach with a low AF recurrence rate. 3D electroanatomical maps of AP contributed to the high success rate of ablation without significantly prolonging of operational duration and X-ray exposure time.
authors.affiliation: Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Xiang-fei
authors.initials: XF
authors.lastname: Feng
authors.forename: Qun-shan
authors.initials: QS
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Peng-pai
authors.initials: PP
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.forename: Yue-peng
authors.initials: YP
authors.lastname: Wang
authors.forename: Yi-gang
authors.initials: YG
authors.lastname: Li
mesh_terms: D058606:Accessory Atrioventricular Bundle; D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004554:Electric Countershock; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery*