Skip Navigation


Europace Advance Access originally published online on August 29, 2008
Europace 2008 10(11):1281-1287; doi:10.1093/europace/eun244
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
10/11/1281    most recent
eun244v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Estner, H. L.
Right arrow Articles by Deisenhofer, I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Estner, H. L.
Right arrow Articles by Deisenhofer, I.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Ablation for atrial fibrillation

Electrogram-guided substrate ablation with or without pulmonary vein isolation in patients with persistent atrial fibrillation

Heidi Luise Estner1,*, Gabriele Hessling1, Gjin Ndrepepa1, JinJin Wu1, Tilko Reents1, Stefanie Fichtner1, Claus Schmitt2, Christian V. Bary1, Christof Kolb1, Martin Karch2, Bernhard Zrenner1 and Isabel Deisenhofer1

1 Deutsches Herzzentrum München and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Lazarettstrasse 36, D-80636 München, Germany; 2 Städtisches Klinikum Karlsruhe, Germany

Aims: Ablation of complex fractionated atrial electrograms (CFAEs) is a new approach for the treatment of atrial fibrillation (AF). The purpose of the study was to assess the efficacy of CFAE ablation as a stand-alone strategy in patients with persistent AF and to compare it with a combined approach of CFAE ablation and pulmonary vein isolation (PVI).

Methods and results: The study included 77 consecutive patients with persistent AF who underwent radiofrequency (RF) ablation of CFAE as a sole ablation procedure (CFAE group, n = 23 patients) or a combined approach of CFAE ablation and PVI (CFAE plus PVI group, n = 54 patients). Procedures were guided by three-dimensional mapping systems. After the procedure, AF recurrences were evaluated with 7-day Holter recordings at 1, 3, and 6 months and every 6 months thereafter. Treatment failure was defined as ≥1 AF episode lasting >30 s on Holter recordings during follow-up. After a mean follow-up time of 13 ± 10 months, 2 of 23 patients (9%) with CFAE ablation and 22 of 54 patients (41%) with CFAE plus PVI were in sinus rhythm after a single ablation procedure without anti-arrhythmic medication (P = 0.008).

Conclusion: Ablation of CFAE as a stand-alone ablation strategy seems insufficient for the treatment of patients with persistent AF. Pulmonary vein isolation plus CFAE ablation significantly increases the mid-term success rate.

Key Words: Persistent atrial fibrillation, Ablation, Pulmonary vein isolation, Complex fractionated atrial electrograms

* Corresponding author. Tel: +49 89 12182020; fax: +49 89 12184593. E-mail address: estner{at}dhm.mhn.de

Manuscript submitted 22 June 2008. Accepted after revision 8 August 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.