The clinical evaluation of circumferential pulmonary vein isolation in cases with persistent atrial fibrillation / 中国介入心脏病学杂志

ABSTRACT

Objective To evaluate the safety and effectiveness of circumferential pulmonary vein(PV) isolation in cases with persistent/permanent atrial fibrillation(AF) guided by the EnSite-NavX system.Methods Sixty cases(43 males,mean age 59.2?13.6 years) with persistent/permanent AF were enrolled from September 2004 to August 2005.The mean duration of AF was 4?6 years(6 months-24 years).The mean left atrium diameter was 43.2?6.4(42-58)mm.Circumferential PV isolation was performed guided by the EnSite-NavX system,combined with linear ablation of the superior-posterior wall of left atrium and mitral isthmus.Results All 60 cases underwent the procedure successfully,with the mean procedural time 170?34(150-240)min and the mean fluoroscopic time 23?10(12-45)min.The pulmonary vein isolation rate for the left ipsilateral PVs was 83.3% and was 78.3% for the right PVs.Segmental ostial ablation was applied for the rest cases.AF was terminated in 7 cases and was converted to atrial tachycardia(AT) or atrial flutter(AFL) in 5 cases.Sinus rhythm was restored by cardioversion in 48 cases.Post-ablation AT/AFL was documented in 10 cases (16.7%) which diminished automatically in 8 cases,and was abolished by re-ablation in 2 cases.After a mean of 6.5?3.2(4-11)months of follow-up,43 cases (71.7%) were free of AF(18 cases with anti-arrhythmic drugs).Complications pseudo-aneurysm of femoral artery was found in 1 case and was cured after proper treatment.Conclusion Circumferential PV isolation and combination with left atrial linear ablation guided by the EnSite-NavX system was safe and effective for eliminating persistent/permanent AF.