دورية أكاديمية
Electrical isolation of the superior vena cava: an adjunctive strategy to pulmonary vein antrum isolation improving the outcome of AF ablation.
| العنوان: | Electrical isolation of the superior vena cava: an adjunctive strategy to pulmonary vein antrum isolation improving the outcome of AF ablation. |
|---|---|
| المؤلفون: | Arruda M; Center for Atrial Fibrillation, Cleveland Clinic, Cleveland, Ohio, USA., Mlcochova H, Prasad SK, Kilicaslan F, Saliba W, Patel D, Fahmy T, Morales LS, Schweikert R, Martin D, Burkhardt D, Cummings J, Bhargava M, Dresing T, Wazni O, Kanj M, Natale A |
| المصدر: | Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2007 Dec; Vol. 18 (12), pp. 1261-6. Date of Electronic Publication: 2007 Sep 11. |
| نوع المنشور: | Clinical Trial; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Malden, MA : Blackwell Original Publication: Mt. Kisco, N.Y. : Futura Pub., c1990- |
| مواضيع طبية MeSH: | Atrial Fibrillation/*epidemiology , Atrial Fibrillation/*surgery , Catheter Ablation/*statistics & numerical data , Heart Conduction System/*surgery , Pulmonary Veins/*surgery , Vena Cava, Superior/*surgery, Atrial Fibrillation/diagnosis ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Ohio/epidemiology ; Treatment Outcome |
| مستخلص: | Unlabelled: PV isolation at the antrum (PVAI) has improved safety and efficacy of ablation procedures for atrial fibrillation (AF). AF triggers from the superior vena cava (SVC) may compromise the outcome of PVAI. Purpose: We evaluated the (1) incidence of SVC triggers, (2) feasibility of empiric SVC electrical isolation (SVCI) as an adjunct to PVAI, and (3) SVCI safety. Methods and Results: Of 190 patients (group I), 24 (12%) showed SVC triggers. Following PVAI, seven patients had AT originating from the SVC and three had AF. After SVCI, all 24 patients were arrhythmia-free 450 +/- 180 days post procedure. In the subsequent 217 patients (group II), empirical SVCI was performed following PVAI. Sixty-six of all 407 patients (16%) experienced recurrence of AF. A repeat procedure in 25 of the 66 patients showed that five (20%) had AF recurrence initiated by SVC triggers, of whom four were among group I patients (4/190; 2%) and one was from group II (1/217; 0.4%), (P < 0.05). Transient diaphragmatic paralysis can be avoided by pacing at the lateral aspect of the SVC using high output (30 mA). There was no SVC stenosis on CT scans before or 3 months after the procedure. There was no sinus node injury. Conclusions: The SVC harbors the majority of non-PV triggers of AF. SVCI is feasible, safe, and may be considered as an adjunctive strategy to PVAI for ablation of AF. The long-term favorable outcome of this hybrid approach remains to be evaluated in a larger series of patients. |
| التعليقات: | Comment in: J Cardiovasc Electrophysiol. 2007 Dec;18(12):1267-8. (PMID: 17971151) |
| تواريخ الأحداث: | Date Created: 20070914 Date Completed: 20080107 Latest Revision: 20220318 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1111/j.1540-8167.2007.00953.x |
| PMID: | 17850288 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1540-8167 |
|---|---|
| DOI: | 10.1111/j.1540-8167.2007.00953.x |