Studies have demonstrated that myocardium surrounding pulmonary vein (PV) ostia plays
an important role in the initiation and perpetuation of atrial fibrillation (AF).
1
,
2
This important finding has led to the development of segmental PV ostial isolation,
circumferential ablation, and isolation around the PVs using circular linear lesions
guided by three-dimensional (3D) electroanatomic mapping. Substrate modification using
limited linear ablation also has been demonstrated to improve the clinical outcome
after PV isolation in patients with AF inducibility. However, in the majority of ablation
centers the most useful method is PV isolation using either segmental PV isolation
or complete PV isolation guided by 3D mapping and Lasso catheters. Here we describe
our technique for left atrial (LA) ablation in patients with paroxysmal or persistent
AF.Keywords
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References
- Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.N Engl J Med. 1998; 339: 659-666
- Complete isolation of left atrium surrounding the pulmonary veins: new insights from the double-Lasso technique in paroxysmal atrial fibrillation.Circulation. 2004; 110: 2090-2096
- External and endoluminal analysis of left atrial anatomy and the pulmonary veins in three-dimensional reconstructions of magnetic resonance angiography: the full insight from inside.J Cardiovasc Electrophysiol. 2006; 17: 957-964
- Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique.Circulation. 2005; 112: 3038-3048
- A single pulmonary vein as electrophysiological substrate of paroxysmal atrial fibrillation.J Cardiovasc Electrophysiol. 2006; 17: 1193-2201
- Recovered pulmonary vein conduction as a dominant factor for recurrent atrial tachyarrhythmias after complete circular isolation of the pulmonary veins: lessons from double Lasso technique.Circulation. 2005; 111: 127-135
- Characterization of reentrant circuits in left atrial macroreentrant tachycardia: critical isthmus block can prevent atrial tachycardia recurrence.Circulation. 2002; 105: 1934-1942
- Long-term evaluation of atrial fibrillation ablation guided by noninducibility.Heart Rhythm. 2006; 3: 140-145
- Noninducibility of atrial fibrillation as an end point of left atrial circumferential ablation for paroxysmal atrial fibrillation: a randomized study.Circulation. 2004; 110: 2797-2801
Article info
Publication history
Published online: December 27, 2006
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© 2007 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
