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Europace Advance Access published online on May 19, 2008
Europace, doi:10.1093/europace/eun131
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions©oxfordjournals.org.

Inducibility of atrial tachyarrhythmias after circumferential pulmonary vein isolation in patients with paroxysmal atrial fibrillation: clinical predictor and outcome during follow-up

Kazuhiro Satomi, Roland Tilz, Seiji Takatsuki, Julian Chun, Boris Schmidt, Dietmar Bänsch, Matthias Antz, Thomas Zerm, Andreas Metzner, Bülent Köktürk, Sabine Ernst, Heiner Greten, Karl-Heinz Kuck and Feifan Ouyang*

II. Med. Abteilung, Asklepios Klinik St Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany

Aims: We investigated the presence and clinical outcome of inducibility of atrial tachyarrhythmias after circumferential pulmonary vein isolation (CPVI) in patients with paroxysmal atrial fibrillation (PAF).

Methods and results: Sixty patients with symptomatic PAF underwent CPVI guided by 3D mapping and double Lasso technique. After achievement of CPVI, the induction was performed. The left atrium (LA) volume and the isolated LA area around the right and left-sided pulmonary veins were measured by the 3D mapping system. Sustained atrial tachyarrhythmias (>10 min) were induced after CPVI in 17 of 60 patients (28%). Patients with inducible atrial tachyarrhythmias had significantly smaller isolated areas when compared with the group with non-inducible tachyarrhythmias (16.7 ± 2.3 vs. 18.8 ± 2.9%, P < 0.05). After the initial procedure, recurrence occurred in 18 of 43 (42%) patients in the non-inducible group and in 7 of 17 (41%) in the inducible group during follow-up. A repeat procedure was performed in all 25 patients with recurrence. Five patients had a recurrence after the repeat procedure during 20.8 ± 7.5 months, and there was no difference between the two groups.

Conclusion: Inducibility of atrial tachyarrhythmias is associated with proportionally smaller isolated area and does not predict the clinical efficacy of CPVI in patients with PAF.

Key Words: Atrial fibrillation, Catheter ablation, Electrophysiology

* Corresponding author. Tel: +49 40 2890 3616; fax: +49 40 2890 4435. E-mail address: ouyangfeifan{at}aol.com

Manuscript submitted 11 February 2008. Accepted after revision 28 April 2008.


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