1. Trigger activity more than three years after left atrial linear ablation without pulmonary vein isolation in patients with atrial fibrillation.
- Author
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Tanner H, Hindricks G, Kobza R, Dorszewski A, Schirdewahn P, Piorkowski C, Gerds-Li JH, and Kottkamp H
- Subjects
- Atrial Premature Complexes diagnosis, Female, Follow-Up Studies, Heart Atria surgery, Humans, Male, Middle Aged, Recurrence, Time Factors, Atrial Fibrillation surgery, Catheter Ablation, Electrocardiography, Heart Conduction System physiopathology
- Abstract
Objectives: The aim of this study was to analyze trigger activity in the long-term follow-up after left atrial (LA) linear ablation., Background: Interventional strategies for curative treatment of atrial fibrillation (AF) are targeted at the triggers and/or the maintaining substrate. After substrate modification using nonisolating linear lesions, the activity of triggers is unknown., Methods: With the LA linear lesion concept, 129 patients were treated using intraoperative ablation with minimal invasive surgical techniques. Contiguous radiofrequency energy-induced lesion lines involving the mitral annulus and the orifices of the pulmonary veins without isolation were placed under direct vision., Results: After a mean follow-up of 3.6 +/- 0.4 years, atrial ectopy, atrial runs, and reoccurrence of AF episodes were analyzed by digital 7-day electrocardiograms in 30 patients. Atrial ectopy was present in all patients. Atrial runs were present in 25 of 30 patients (83%), with a median number of 9 runs per patient/week (range 1 to 321) and a median duration of 1.2 s/run (range 0.7 to 25), without a significant difference in atrial ectopy and atrial runs between patients with former paroxysmal (n = 17) or persistent AF (n = 13). Overall, 87% of all patients were completely free from AF without antiarrhythmic drugs., Conclusions: A detailed rhythm analysis late after specific LA linear lesion ablation shows that trigger activity remains relatively frequent but short and does not induce AF episodes in most patients. The long-term success rate of this concept is high in patients with paroxysmal or persistent AF.
- Published
- 2005
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