Ablation of right and left atrial premature beats following cardioversion in patients with chronic atrial fibrillation refractory to antiarrhythmic drugs

Pisanó, Ennio; Beheiry, Salwa; Richey, Mark; Leonelli, Fabio M.; Fanelli, Raffaele; Potenza, Mimmo; Tomassoni, Gery

doi:10.1016/s0002-9149(00)00774-8

Cited by 31 publications

(13 citation statements)

References 4 publications

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“…Whereas electrophysiological mapping has indicated that myocardial areas in both the RA and LA may be responsible for activating atrial premature complexes in patients with AF (Natale et al. ), there are indications that electrical remodeling is altered differentially in RA as compared to LA in patients with AF (Caballero et al. ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of left versus right atrial myocardium in patients with sinus rhythm or atrial fibrillation - an assessment of mitochondrial function and microRNA expression

et al. 2014

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Several of the cellular alterations involved in atrial fibrillation (AF) may be linked to mitochondrial function and altered microRNA (miR) expression. A majority of studies on human myocardium involve right atrial (RA) tissue only. There are indications that AF may affect the two atria differentially. This study aimed to compare interatrial differences in mitochondrial respiration and miR expression in the RA versus left atrium (LA) within patients with sinus rhythm (SR) and AF. Thirty‐seven patients with AF (n = 21) or SR (n = 16), undergoing coronary artery bypass surgery and/or heart valve surgery, were included. Myocardial biopsies were obtained from RA and LA appendages. Mitochondrial respiration was assessed in situ in permeabilized myocardium. MiR array and real‐time quantitative polymerase chain reaction were performed to evaluate miR expression. Mitochondrial respiratory rates were similar in RA versus LA. Expression of miR‐100, ‐10b, ‐133a, ‐133b, ‐146a, ‐155, ‐199a‐5p, ‐208b, and ‐30b were different between the atria in both SR and AF patients. In contrast, differential expression was observed between RA versus LA for miR‐93 in patients with SR only, and for miR‐1, ‐125b, ‐142‐5p, ‐208a, and ‐92b within AF patients only. These results indicate that mitochondrial respiratory capacity is similar in the RA and LA of patients with SR and AF. Differences in miR expressional profiles are observed between the RA versus LA in both SR and AF, and several interatrial differences in miR expression diverge between SR and AF. These findings may contribute to the understanding of how AF pathophysiology may affect the two atria differently.

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Section: Discussionmentioning

confidence: 99%

Comparison of left versus right atrial myocardium in patients with sinus rhythm or atrial fibrillation - an assessment of mitochondrial function and microRNA expression

et al. 2014

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“…Therapies aimed at suppressing premature atrial contractions (PACs) also may be effective. Natale et al 22 demonstrated good arrhythmia control by ablating PACs after electrical cardioversion, combined with pharmacologic therapy. The foci for the PACs were on the left in 62% of the sites mapped.…”

Section: Editorial Commentmentioning

confidence: 99%

Early Recurrence of Atrial Fibrillation:

Joglar

Page

2004

Cardiovasc electrophysiol

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“…[1][2][3][4] Observational studies have reported excellent outcomes after catheter ablation in patients with paroxysmal and worse outcomes for patients with permanent AF. [5][6][7][8][9] The mechanisms for permanent AF are poorly understood but elimination of AF by catheter ablation may depend on modification of the AF substrate rather than the abolition of triggers from independently firing foci in the pulmonary veins (PVs). 10 Therefore, segmental PV isolation alone is rarely sufficient in this group.…”

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confidence: 99%

Catheter ablation of permanent atrial fibrillation: medium term results

Earley

Abrams²,

Staniforth³

et al. 2006

Heart

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Objective: To investigate the feasibility of catheter ablation as a treatment for symptomatic patients with longstanding permanent atrial fibrillation (AF). Methods: Radiofrequency ablation was applied to encircle all pulmonary veins (PVs) and create lines from the left inferior PV to the mitral valve, along the roof of the left atrium between the PVs, and along the tricuspid valve-inferior vena cava isthmus. A seven day Holter was recorded at discharge and at follow up to assess arrhythmia burden. If patients developed a symptomatic, sustained atrial arrhythmia a repeat ablation procedure was advised. Results: 42 patients underwent the procedure that took a mean of five hours with 50 minutes of fluoroscopy. After a median follow up of 8.4 months, 31 of 41 surviving patients (76%) were in sinus rhythm. Of these, 29 patients were no longer taking any antiarrhythmic drugs but 22 (52%) required more than one procedure. During follow up 49% experienced a sustained atrial tachycardia. Twenty six repeat procedures were performed. Maintenance of sinus rhythm after the first, second, or third procedure was 36% (15 of 42), 58% (11 of 19), and 71% (5 of 7), respectively. From a total of 68 procedures there were two serious complications (2.9%): a stroke from which a full recovery was made, and a PV stenosis. Conclusion: Catheter ablation can be used to cure longstanding permanent AF; however, there is a significant complication rate. Whether this is offset by a mortality benefit associated with sinus rhythm is unknown. Many patients will need more than one procedure to achieve success.

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Ablation of right and left atrial premature beats following cardioversion in patients with chronic atrial fibrillation refractory to antiarrhythmic drugs

Cited by 31 publications

References 4 publications

Comparison of left versus right atrial myocardium in patients with sinus rhythm or atrial fibrillation - an assessment of mitochondrial function and microRNA expression

Comparison of left versus right atrial myocardium in patients with sinus rhythm or atrial fibrillation - an assessment of mitochondrial function and microRNA expression

Early Recurrence of Atrial Fibrillation:

Catheter ablation of permanent atrial fibrillation: medium term results

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