Radiofrequency Ablation of Atrial Fibrillation

pp 90-100

Abstract

Discovery of the origin of atrial fibrillation (AF)inside the pulmonary veins (PVs) allowed the development of new techniques of isolation of the PVs with radiofrequency energy. We performed PVs ablation in 7 patients with paroxysmal AF refractory to antiarrhythmic medication. We performed successful isolation of 22 PVs in 7 patients(22/28 PVs or 79%), an average of 3.1±0.8 PVs per patient. In 3 patients (43%) we isolated all 4 PVs, in 2 patients (28%) we isolated 3 PVs, and the last2 patients (28%) we isolated only the 2 superiorPVs. Both superior PVs were ablated in all the patients. The right inferior PV was ablated in 3 out of 7 patients (43%) and the left inferior in 5 out of7 patients (71%). The mean number of lesions was 25±7 per patient. Procedure time and fluoroscopy time were 236±61 min y 69±19 min, respectively.The inner diameter of the PVs did not change significantly post ablation. There were no complications. The mean follow up was 58 ± 35 days. Recurrence of atrial arrhythmias, either AF (n = 2) or atrial flutter (n = 1) occurred in 3 out of 7 patients(43%). The curative success of the procedure was57%. We concluded that empiric radiofrequency ablation of the PVs is safe and effective for the curative treatment of paroxysmal atrial fibrillation.The indications for this procedure should be re-served for patients with frequent recurrences ofAF unresponsive to antiarrhythmic medication.