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Article Abstract
Objective: To study the feasibility, safety, effectiveness of linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system.
Methods: Twenty-eight consecutive patients with drug refractory paroxysmal and persistent AF were included in this study. Real-time 3-dimensional left atrial (LA) and pulmonary veins (PVs) maps were constructed through 3-dimensional mapping system (Ensite NavX) in all patients. Pulmonary vein isolation was performed by encircling the left and right sides of PVs at 1 to 2 cm away from the ostium of PVs. The endpoint of ablation included: All circum PVs ablation lines finished; all PVs were isolated; and non-inducibility of AF was observed.
Results: All 28 patients reached the endpoint of ablation completely. The mean procedure time and fluoroscopy time was (161.3+/-23.2) min and (38.0+/-6.8) min, respectively. During the 6 approximately 17 month follow-up, 20 patients (71%) were free of AF without any antiarrhythmic drugs. Recurrence of AF was found in the other 8 patients (29%): Two were treated with amiodarone and 6 repeated ablation. After the second ablation, 4 were free of AF and 2 recurrence were treated with amiodarone. No complications occurred during the procedure and the follow-up.
Conclusion: Linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system is effective and safe. But the long-term outcome remains to be investigated.
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