From the Division of Cardiology, Hospital of Asti (F.G., R.R., L.C.,
M.S., L.G., F.L., E.R.); the Department of Physics, University of Trento
(R.A.); and CMBM (R.A., M.K.), Trento, Italy.
Correspondence to Fiorenzo Gaita, MD, Division of Cardiology, Hospital of Asti, Via Botallo 4, 14100 Asti, Italy. E-mail cardclin{at}provincia.asti.it
Background—Knowledge of the
electrophysiological substrates and the
cure of atrial fibrillation (AF) is still unsatisfactory. The goal of
this study was to evaluate the
electrophysiological features of idiopathic
AF and their relationship to the results of radiofrequency (RF)
catheter ablation of AF and the safety and effectiveness of this
procedure.
Methods and Results—Sixteen patients with idiopathic AF underwent
atrial mapping during AF and then RF ablation in the right atrium. The
atrial activation was simultaneously recorded in four
regions in the right atrium: high lateral wall (HL), low lateral wall
(LL), high septum (HS), and low septum (LS) and in the left atrium
through the coronary sinus (CS). In these regions, we evaluated
the atrial fibrillation intervals (FF) and the morphological features
of AF recordings by Wells' classification. No complications
occurred during RF ablation. Of the 16 patients, 9 (56%) without AF
recurrences during the follow-up (11±4 months) were considered
successfully ablated. These patients showed a significantly shorter
mean FF interval in the HS and the LS (122±32 and 126±28 ms,
respectively) than in the HL and LL (159±24 and 156±28 ms,
respectively). Moreover, the septum had more irregular electrical
activity with greater beat-to-beat changes in FF and a higher
prevalence of type III AF than the lateral region. The CS had similar
behavior to the septum. Conversely, patients with unsuccessful ablation
had an irregular atrial activity in the lateral wall, septum, and CS
with no significant differences between the different sites.
Conclusions—Right atrial endocardial catheter ablation of AF is a
safe procedure and may be effective in some patients with idiopathic
AF. The atrial mapping during AF showed a more disorganized right
atrial activation in the septum than in the lateral wall in patients
with successful ablation.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Atrial Mapping and Radiofrequency Catheter Ablation in Patients With Idiopathic Atrial Fibrillation
Electrophysiological Findings and Ablation Results
Key Words: fibrillation • catheter ablation • electrophysiology • mapping
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|
|
|
|
|
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|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
|