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Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties

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Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties. / Takahashi, Yoshihide; O'Neill, Mark D; Hocini, Méléze; Reant, Patricia; Jonsson, Anders; Jaïs, Pierre; Sanders, Prashanthan; Rostock, Thomas; Rotter, Martin; Sacher, Frédéric; Laffite, Stephane; Roudaut, Raymond; Clémenty, Jacques; Haïssaguerre, Michel.

In: J AM COLL CARDIOL, Vol. 49, No. 12, 27.03.2007, p. 1306-1314.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Takahashi, Y, O'Neill, MD, Hocini, M, Reant, P, Jonsson, A, Jaïs, P, Sanders, P, Rostock, T, Rotter, M, Sacher, F, Laffite, S, Roudaut, R, Clémenty, J & Haïssaguerre, M 2007, 'Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties', J AM COLL CARDIOL, vol. 49, no. 12, pp. 1306-1314. https://doi.org/10.1016/j.jacc.2006.11.033

APA

Takahashi, Y., O'Neill, M. D., Hocini, M., Reant, P., Jonsson, A., Jaïs, P., Sanders, P., Rostock, T., Rotter, M., Sacher, F., Laffite, S., Roudaut, R., Clémenty, J., & Haïssaguerre, M. (2007). Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties. J AM COLL CARDIOL, 49(12), 1306-1314. https://doi.org/10.1016/j.jacc.2006.11.033

Vancouver

Takahashi Y, O'Neill MD, Hocini M, Reant P, Jonsson A, Jaïs P et al. Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties. J AM COLL CARDIOL. 2007 Mar 27;49(12):1306-1314. https://doi.org/10.1016/j.jacc.2006.11.033

Bibtex

@article{c987bebf925b42a3a504891d3c37123a,
title = "Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties",
abstract = "OBJECTIVES: This study sought to evaluate the effects of stepwise catheter ablation of chronic atrial fibrillation (AF) on atrial electrical and mechanical properties.BACKGROUND: Although stepwise catheter ablation of chronic AF is associated with acute arrhythmia termination and a favorable clinical outcome, atrial tissue damage following the procedure has not been evaluated.METHODS: Forty patients who had previously undergone catheter ablation of chronic AF were studied. In the index procedure, termination of AF was achieved by catheter ablation alone in 36 of 40 patients (90%). Electroanatomical mapping was performed in sinus rhythm > or =1 month after the index procedure, during which the surface area of scar (bipolar voltage of <0.05 mV), low-voltage tissue (<0.5 mV), and atrial propagation were evaluated. Left atrial (LA) mechanical function was assessed by transthoracic echocardiography.RESULTS: Electroanatomical mapping showed areas of scar and low-voltage accounting for 31% +/- 12% and 32% +/- 17% of the total LA surface area respectively, with the ablated pulmonary vein region accounting for 20% +/- 4% of the LA surface area. The area of scar outside the pulmonary vein region represented 14% +/- 12% of the LA surface area using the initial randomized ablation strategy, and 6% +/- 8% (p = 0.02) using a specific ablation strategy. Atrial conduction was diversely affected by ablation with a wide range of LA conduction times observed (range 100 to 360 ms). The LA contraction was shown in all patients by the presence of late diastolic mitral flow (37 +/- 15 cm/s) and a mean LA active emptying fraction of 18 +/- 11%. At 9 +/- 5 months of follow-up, 39 patients (98%) were in sinus rhythm.CONCLUSIONS: Stepwise ablation achieving sinus rhythm in patients with chronic AF has a significant impact on LA electrical activity but is associated with recovery of LA function.",
keywords = "Atrial Fibrillation/physiopathology, Atrial Function, Left/physiology, Body Surface Potential Mapping, Catheter Ablation/methods, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged",
author = "Yoshihide Takahashi and O'Neill, {Mark D} and M{\'e}l{\'e}ze Hocini and Patricia Reant and Anders Jonsson and Pierre Ja{\"i}s and Prashanthan Sanders and Thomas Rostock and Martin Rotter and Fr{\'e}d{\'e}ric Sacher and Stephane Laffite and Raymond Roudaut and Jacques Cl{\'e}menty and Michel Ha{\"i}ssaguerre",
year = "2007",
month = mar,
day = "27",
doi = "10.1016/j.jacc.2006.11.033",
language = "English",
volume = "49",
pages = "1306--1314",
journal = "J AM COLL CARDIOL",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "12",

}

RIS

TY - JOUR

T1 - Effects of stepwise ablation of chronic atrial fibrillation on atrial electrical and mechanical properties

AU - Takahashi, Yoshihide

AU - O'Neill, Mark D

AU - Hocini, Méléze

AU - Reant, Patricia

AU - Jonsson, Anders

AU - Jaïs, Pierre

AU - Sanders, Prashanthan

AU - Rostock, Thomas

AU - Rotter, Martin

AU - Sacher, Frédéric

AU - Laffite, Stephane

AU - Roudaut, Raymond

AU - Clémenty, Jacques

AU - Haïssaguerre, Michel

PY - 2007/3/27

Y1 - 2007/3/27

N2 - OBJECTIVES: This study sought to evaluate the effects of stepwise catheter ablation of chronic atrial fibrillation (AF) on atrial electrical and mechanical properties.BACKGROUND: Although stepwise catheter ablation of chronic AF is associated with acute arrhythmia termination and a favorable clinical outcome, atrial tissue damage following the procedure has not been evaluated.METHODS: Forty patients who had previously undergone catheter ablation of chronic AF were studied. In the index procedure, termination of AF was achieved by catheter ablation alone in 36 of 40 patients (90%). Electroanatomical mapping was performed in sinus rhythm > or =1 month after the index procedure, during which the surface area of scar (bipolar voltage of <0.05 mV), low-voltage tissue (<0.5 mV), and atrial propagation were evaluated. Left atrial (LA) mechanical function was assessed by transthoracic echocardiography.RESULTS: Electroanatomical mapping showed areas of scar and low-voltage accounting for 31% +/- 12% and 32% +/- 17% of the total LA surface area respectively, with the ablated pulmonary vein region accounting for 20% +/- 4% of the LA surface area. The area of scar outside the pulmonary vein region represented 14% +/- 12% of the LA surface area using the initial randomized ablation strategy, and 6% +/- 8% (p = 0.02) using a specific ablation strategy. Atrial conduction was diversely affected by ablation with a wide range of LA conduction times observed (range 100 to 360 ms). The LA contraction was shown in all patients by the presence of late diastolic mitral flow (37 +/- 15 cm/s) and a mean LA active emptying fraction of 18 +/- 11%. At 9 +/- 5 months of follow-up, 39 patients (98%) were in sinus rhythm.CONCLUSIONS: Stepwise ablation achieving sinus rhythm in patients with chronic AF has a significant impact on LA electrical activity but is associated with recovery of LA function.

AB - OBJECTIVES: This study sought to evaluate the effects of stepwise catheter ablation of chronic atrial fibrillation (AF) on atrial electrical and mechanical properties.BACKGROUND: Although stepwise catheter ablation of chronic AF is associated with acute arrhythmia termination and a favorable clinical outcome, atrial tissue damage following the procedure has not been evaluated.METHODS: Forty patients who had previously undergone catheter ablation of chronic AF were studied. In the index procedure, termination of AF was achieved by catheter ablation alone in 36 of 40 patients (90%). Electroanatomical mapping was performed in sinus rhythm > or =1 month after the index procedure, during which the surface area of scar (bipolar voltage of <0.05 mV), low-voltage tissue (<0.5 mV), and atrial propagation were evaluated. Left atrial (LA) mechanical function was assessed by transthoracic echocardiography.RESULTS: Electroanatomical mapping showed areas of scar and low-voltage accounting for 31% +/- 12% and 32% +/- 17% of the total LA surface area respectively, with the ablated pulmonary vein region accounting for 20% +/- 4% of the LA surface area. The area of scar outside the pulmonary vein region represented 14% +/- 12% of the LA surface area using the initial randomized ablation strategy, and 6% +/- 8% (p = 0.02) using a specific ablation strategy. Atrial conduction was diversely affected by ablation with a wide range of LA conduction times observed (range 100 to 360 ms). The LA contraction was shown in all patients by the presence of late diastolic mitral flow (37 +/- 15 cm/s) and a mean LA active emptying fraction of 18 +/- 11%. At 9 +/- 5 months of follow-up, 39 patients (98%) were in sinus rhythm.CONCLUSIONS: Stepwise ablation achieving sinus rhythm in patients with chronic AF has a significant impact on LA electrical activity but is associated with recovery of LA function.

KW - Atrial Fibrillation/physiopathology

KW - Atrial Function, Left/physiology

KW - Body Surface Potential Mapping

KW - Catheter Ablation/methods

KW - Chronic Disease

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

U2 - 10.1016/j.jacc.2006.11.033

DO - 10.1016/j.jacc.2006.11.033

M3 - SCORING: Journal article

C2 - 17394963

VL - 49

SP - 1306

EP - 1314

JO - J AM COLL CARDIOL

JF - J AM COLL CARDIOL

SN - 0735-1097

IS - 12

ER -