The purpose of this article is to describe the technique and results of circumferential
pulmonary vein ablation (CPVA) in patients with atrial fibrillation (AF) as currently
performed in Milan.
1
,
2
,
- Pappone C.
- Oreto G.
- Rosanio S.
- Vicedomini G.
- Tocchi M.
- Gugliotta F.
- Salvati A.
- Dicandia C.
- Calabro M.P.
- Mazzone P.
- Ficarra E.
- Di Gioia C.
- Gulletta S.
- Nardi S.
- Santinelli V.
- Benussi S.
- Alfieri O.
Atrial electroanatomic remodeling after circumferential radiofrequency PV ablation Efficacy of an anatomic approach in a large cohort of patients with AF.
Circulation. 2001; 103: 2539-2544
3
,
- Pappone C.
- Rosanio S.
- Augello G.
- Gallus G.
- Vicedomini G.
- Mazzone P.
- Gulletta S.
- Gugliotta F.
- Pappone A.
- Santinelli V.
- Tortoriello V.
- Sala S.
- Zangrillo A.
- Crescenzi G.
- Benussi S.
- Alfieri O.
Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation
for atrial fibrillation: outcomes from a controlled nonrandomized long-term study.
J Am Coll Cardiol. 2003; 42: 185-197
4
,
- Pappone C.
- Manguso F.
- Vicedomini G.
- Gugliotta F.
- Santinelli O.
- Ferro A.
- Gulletta S.
- Sala S.
- Sora N.
- Paglino G.
- Augello G.
- Agricola E.
- Zangrillo A.
- Alfieri O.
- Santinelli V.
Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation A prospective randomized study comparing circumferential pulmonary vein ablation with
a modified approach.
Circulation. 2004; 110: 3036-3042
5
,
6
,
7
,
8
,
9
,
10
,
11
,
- Lang C.C.
- Santinelli V.
- Augello G.
- Ferro A.
- Gugliotta F.
- Gulletta S.
- Vicedomini G.
- Mesas C.
- Paglino G.
- Sala S.
- Sora N.
- Mazzone P.
- Manguso F.
- Pappone C.
Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral
valve prostheses and enlarged atria: safety, feasibility, and efficacy.
J Am Coll Cardiol. 2005; 45: 868-872
12
,
- Mesas C.E.
- Pappone C.
- Lang C.C.
- Gugliotta F.
- Tomita T.
- Vicedomini G.
- Sala S.
- Paglino G.
- Gulletta S.
- Ferro A.
- Santinelli V.
Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation:
electroanatomic characterization and treatment.
J Am Coll Cardiol. 2004; 44: 1071-1079
13
,
14
Since a significant learning curve still exists with the standard procedure, we have
recently developed a new system, called remote magnetic navigation and ablation, which
can be performed by less experienced operators while at the same time still reducing
complications.
- Lang C.C.
- Gugliotta F.
- Santinelli V.
- Mesas C.
- Tomita T.
- Vicedomini G.
- Augello G.
- Gulletta S.
- Mazzone P.
- De Cobelli F.
- Del Maschio A.
- Pappone C.
Endocardial impedance mapping during circumferential pulmonary vein ablation of atrial
fibrillation differentiates between atrial and venous tissue.
Heart Rhythm. 2006; 3: 171-178
13
The results of our standard technique with manually deflectable catheters are based
on about 10,000 patients with paroxysmal, persistent, or permanent AF, many of whom
have structural heart disease.
1
,
2
,
- Pappone C.
- Oreto G.
- Rosanio S.
- Vicedomini G.
- Tocchi M.
- Gugliotta F.
- Salvati A.
- Dicandia C.
- Calabro M.P.
- Mazzone P.
- Ficarra E.
- Di Gioia C.
- Gulletta S.
- Nardi S.
- Santinelli V.
- Benussi S.
- Alfieri O.
Atrial electroanatomic remodeling after circumferential radiofrequency PV ablation Efficacy of an anatomic approach in a large cohort of patients with AF.
Circulation. 2001; 103: 2539-2544
3
,
- Pappone C.
- Rosanio S.
- Augello G.
- Gallus G.
- Vicedomini G.
- Mazzone P.
- Gulletta S.
- Gugliotta F.
- Pappone A.
- Santinelli V.
- Tortoriello V.
- Sala S.
- Zangrillo A.
- Crescenzi G.
- Benussi S.
- Alfieri O.
Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation
for atrial fibrillation: outcomes from a controlled nonrandomized long-term study.
J Am Coll Cardiol. 2003; 42: 185-197
4
,
- Pappone C.
- Manguso F.
- Vicedomini G.
- Gugliotta F.
- Santinelli O.
- Ferro A.
- Gulletta S.
- Sala S.
- Sora N.
- Paglino G.
- Augello G.
- Agricola E.
- Zangrillo A.
- Alfieri O.
- Santinelli V.
Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation A prospective randomized study comparing circumferential pulmonary vein ablation with
a modified approach.
Circulation. 2004; 110: 3036-3042
5
,
6
,
7
,
8
,
9
,
10
,
11
,
- Lang C.C.
- Santinelli V.
- Augello G.
- Ferro A.
- Gugliotta F.
- Gulletta S.
- Vicedomini G.
- Mesas C.
- Paglino G.
- Sala S.
- Sora N.
- Mazzone P.
- Manguso F.
- Pappone C.
Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral
valve prostheses and enlarged atria: safety, feasibility, and efficacy.
J Am Coll Cardiol. 2005; 45: 868-872
12
At present, remote magnetic navigation and ablation has been performed safely in
about 200 patients with paroxysmal, persistent, or permanent AF.- Mesas C.E.
- Pappone C.
- Lang C.C.
- Gugliotta F.
- Tomita T.
- Vicedomini G.
- Sala S.
- Paglino G.
- Gulletta S.
- Ferro A.
- Santinelli V.
Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation:
electroanatomic characterization and treatment.
J Am Coll Cardiol. 2004; 44: 1071-1079
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References
- Circumferential radiofrequency ablation of PV ostia.Circulation. 2000; 102: 2619-2628
- Atrial electroanatomic remodeling after circumferential radiofrequency PV ablation.Circulation. 2001; 103: 2539-2544
- Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation: outcomes from a controlled nonrandomized long-term study.J Am Coll Cardiol. 2003; 42: 185-197
- Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation.Circulation. 2004; 110: 3036-3042
- PV denervation enhances long-term benefit after circumferential ablation for paroxysmal AF.Circulation. 2004; 109: 327-334
- The who, what, why, and how-to guide for circumferential pulmonary vein ablation.J Cardiovasc Electrophysiol. 2004; 15: 1226-1230
- Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of AF.Circulation. 2004; 109: 2724-2726
- Atrial fibrillation ablation: state of the art.Am J Cardiol. 2005; 96: 59L-64L
- Atrial fibrillation ablation: a realistic alternative to pharmacologic therapy.Nat Clin Pract Cardiovasc Med. 2005; 2: 608-609
- Towards a unified strategy for atrial fibrillation ablation?.Eur Heart J. 2005; 26: 1687-1688
- Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral valve prostheses and enlarged atria: safety, feasibility, and efficacy.J Am Coll Cardiol. 2005; 45: 868-872
- Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: electroanatomic characterization and treatment.J Am Coll Cardiol. 2004; 44: 1071-1079
- Robotic magnetic navigation for atrial fibrillation ablation.J Am Coll Cardiol. 2006; 47: 1390-1400
- Endocardial impedance mapping during circumferential pulmonary vein ablation of atrial fibrillation differentiates between atrial and venous tissue.Heart Rhythm. 2006; 3: 171-178
Article info
Publication history
Published online: March 15, 2006
Identification
Copyright
© 2006 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
