Catheter ablation guided by three-dimensional electroanatomic mapping system in combination with pulmonary vein antrum potential in patients with atrial fibrillation

Xiaomei LI; Fuli HU; Xiaoyong QI; Meixia LIU; Bing LIU

ABSTRACT

BACKGROUND:

Presently used pulmonary vein antrum location methods mainly performed by three-dimensional electroanatomy combined with X-ray image or CT image fusion.These methods conducted vein antrum location and ablation by anatomy instructions.It is still poorly understood whether the ablation hit the key part of atrial fibrillation.

OBJECTIVE:

To explore the feasibility of catheter ablation guided by three-dimensional electroanatomic mapping system in conjunct with pulmonary vein antrum potential in patients with atrial fibrillation.DESIGN,TIME AND

SETTING:

The verification clinical study was performed at the Department of Cardiology of Jinan Fourth People's Hospital and Hebei People's Hospital from March 2007 to June 2009.

PARTICIPANTS:

Fifty-one patients with drugs refractory,paroxysmal atrial fibrillation were included.

METHODS:

All patients underwent circumferential pulmonary vein antrum ablation guided by three-dimensional electroanatomic mapping system (CARTO) in conjunct with pulmonary vein antrum potential with the endpoint of electrical isolation.Relevant parameters and ablation success rate were observed.MAIN OUTCOME

MEASURES:

Procedure-related parameters,such as procedure duration,fluoroscopy duration,cumulative success rate and complication were observed.

RESULTS:

Pulmonary veins were isolated in all 51 patients.The mean procedure duration,fluoroscopy time and radiofrequency ablation duration are respectively (207±36.7) minutes,(38.2±14.3) minutes,(56.4±15.7) minutes.After (17.5±3.8)-months follow-up,forty (78.4%) patients did not have recurrence of atrial fibrillation,atrial flutter or atrial tachycardia.No severe procedure-related complication had happened.

CONCLUSION:

Pulmonary vein antrum potential can be used as a landmark to define pulmonary vein antrum,that combined with CARTO system to guide pulmonary vein antrum ablation is effective,safety and feasible for catheter ablation of atrial fibrillation.