ABSTRACT
Pulmonary veins (PV) display a variety of anomalies with a common trunk of the inferior pulmonary veins being the most infrequent. We report on a 65-year-old man who underwent an ablation procedure for atrial fibrillation (AF) exclusively based on electro-anatomical mapping. After recurrence of AF, a common trunk of the inferior PV was detected by computed tomography imaging resulting in a modified ablation approach. Due to a possible role of the common inferior trunk for the initiation of AF, a repeat procedure was performed by en bloc isolation of the common inferior trunk with the left superior PV. The right superior PV was ablated separately. Off antiarrhythmic medication, the patient has remained free of any arrhythmia during a 14 month follow-up.
Subject(s)
Atrial Fibrillation/diagnostic imaging , Atrial Fibrillation/surgery , Heart Conduction System/abnormalities , Heart Conduction System/diagnostic imaging , Pulmonary Veins/abnormalities , Pulmonary Veins/diagnostic imaging , Tomography, X-Ray Computed/methods , Aged , Heart Conduction System/surgery , Humans , Male , Pulmonary Veins/surgeryABSTRACT
AIMS: Catheter Ablation for the Cure of Atrial Fibrillation 2 study is a prospective, randomized trial aimed to demonstrate the efficacy of catheter ablation with combined lesions in the right and left atria, in preventing atrial fibrillation (AF) recurrences among patients with recurrent persistent AF refractory to one antiarrhythmic drug, in comparison with the best pharmacological therapy. METHODS AND RESULTS: Enrolment is limited to patients aged between 18 and 70 years who have experienced at least one documented relapse of persistent AF during antiarrhythmic drug therapy. One hundred and twenty-six patients will be randomized to ablation or antiarrhythmic drug therapy in a 2 : 1 manner. In the ablation group, the patients will undergo right and left atrial linear ablation. Control group patients will be treated with the best antiarrhythmic drug. After an initial blanking period of 2 months patients will be followed for 24 months. Primary endpoint of the study is the absence of documented persistent atrial tachyarrhythmias relapse during the first 24 months after the blanking period. Enrolment is scheduled in 14 centres in Italy, UK, Austria, and Finland. Seventy-two patients have currently been enrolled. CONCLUSION: This study will provide important data about the efficacy of catheter ablation in comparison with antiarrhythmic drugs for the treatment of persistent AF.
