Safety and efficacy of circumferential pulmonary vein linear ablation guided by 3-D mapping system in patients with atrial fibrillation / 中国实用内科杂志

ABSTRACT

Objective To investigate the safety and efficacy of circumferential pulmonary vein linear ablation guided by 3-D mapping system in patients with atrial fibrillation.Methods From April 2003 to March 2006,410 consecutive patients with atrial fibrillation underwent circumferential pulmonary vein linear ablation guided by 3-D mapping system(CARTO system or EnSite NavX TM system).Success was defined as symptomatic atrial tachyarrhythmia free after 3 months washout period.Results 96%of the 410 patients attained the ablation endpoint.After a mean of (12.4?6.8)months' follow-up,clinical success achieved in 77.3% of the patients with paroxysmal atrial fibrillation and 69.4% of the patients with persistent/permanent atrial fibrillation after first-time ablation procedure.The successs rate of the persistent/permanent atrial fibrillation was significantly lower than that of paroxysmal atrial fibrillation.Forty-one of the 103 patients with recurrent atrial fibrillation underwent ablation again.Thirty-one of the 41 patients(75.6%)were atrial tachyarrhythmia free during the follow-up.Severe complications included 4 cases of pericardial tamponade(0.97%)and 3 cases of stroke(0.73%).Pericardial tamponades were relieved by pericardiocentesis.The patients with stroke recovered well without any lingering effects.There was no death case.Conclusion Circumferential pulmonary vein linear ablation guided by 3-D mapping system is an effective therapy for atrial fibrillation patients with an acceptable safety.