Blocking the Pulmonary Vein to Left Atrium Conduction in Addition to the Entrance Block Enhances Clinical Efficacy in Atrial Fibrillation Ablation

Chen, Songwen; Meng, Weidong; He, Ding Sheng; Chen, Gang; zhang, Feng; Yi, Yan; Zhuge, Ying; Liu, Shaowen

doi:10.1111/j.1540-8159.2012.03343.x

Cited by 35 publications

(38 citation statements)

References 19 publications

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“…The preoperative preparation has previously been described in detail [11,12]. The ablation procedure was performed while patients were under sedation with a bolus of midazolam and analgesia with a continuous infusion of fentanyl [11].…”

Section: Preoperative Preparation and Ablation Proceduresmentioning

confidence: 99%

Clinical implications of and factors influencing dissociated pulmonary vein potentials

Chen¹,

Wang²,

Chen

et al. 2015

Journal of Cardiology

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Section: Preoperative Preparation and Ablation Proceduresmentioning

confidence: 99%

Clinical implications of and factors influencing dissociated pulmonary vein potentials

Chen¹,

Wang²,

Chen

et al. 2015

Journal of Cardiology

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“…Also, in cases with unidirectional entrance block into the PV, these maneuvers cannot be applied [15, 16]. A potential advantage over maneuvers based on excitability is that they require catheter stability at all sites of the ablation line to check for pace capture, and increase significantly procedure time (a mean of >40 min in one study) [14].…”

Section: Discussionmentioning

confidence: 99%

Atrial mapping during pulmonary vein pacing: a novel maneuver to detect and close residual conduction gaps in an ablation line

Salas

Castellanos

Peinado

et al. 2016

J Interv Card Electrophysiol

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BackgroundLocation of residual conduction gaps on ablation lines around pulmonary veins (PV) is challenging, and several maneuvers have been described. Atrial mapping during PV pacing—the “pace and map” maneuver—could localize gaps.Methods and resultsWe prospectively studied 209 patients undergoing PV isolation at a single institution over a 25-month period. In 24 (11.4 %) patients, 26 PV remained connected after an ablation line and an initial conventional gap closure protocol. The atrial side of the ablation line was mapped with the ablation catheter during PV pacing, and the earliest site was considered a gap site. Ablation at these gap sites resulted in bidirectional PV conduction block in 22 PV (85 %) in 21 patients (88 %), after 2.2 ± 1.6 radiofrequency applications and 8.2 ± 4.8 min. Early PV reconnection (≥20 min) occurred in 0 PV (0 %). During a mean follow-up of 12 ± 6 months, eight patients (33 %) had arrhythmia recurrences.ConclusionsThe “pace and map” maneuver is a relatively simple and efficacious means to identify gaps in ablation lines around PV, focusing on the atrial rather than the PV side of the line. It could be considered among the ways to eliminate residual conduction gaps.

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“…The preoperative preparation procedures are described in detail in our previous publications2526. The radiofrequency catheter ablation procedure was performed while the AF patients were under sedation (via a bolus of midazolam) and analgesia (via a continuous infusion of fentanyl)25.…”

Section: Methodsmentioning

confidence: 99%

“…The radiofrequency catheter ablation procedure was performed while the AF patients were under sedation (via a bolus of midazolam) and analgesia (via a continuous infusion of fentanyl)25. The protocol for AF ablation was previously described in detail2526. A multipolar electrode 6 F catheter was placed in the coronary sinus.…”

Section: Methodsmentioning

confidence: 99%

Association of SCN10A Polymorphisms with the Recurrence of Atrial Fibrillation after Catheter Ablation in a Chinese Han Population

Wang

Chen

et al. 2017

Sci Rep

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The nonsynonymous SCN10A single nucleotide polymorphism (SNP) rs6795970 has been reported to associate with PR interval and atrial fibrillation (AF) and in strong linkage disequilibrium (LD) with the AF-associated SNP rs6800541. In this study, we investigated whether rs6795970 polymorphisms are associated with AF recurrence after catheter ablation. A total of 502 consecutive patients with AF who underwent catheter ablation were included. AF recurrence was defined as a documented episode of any atrial arrhythmias lasting ≥30 s after a blanking period of 3 months. AF recurrence was observed between 3 and 12 months after catheter ablation in 24.5% of the patients. There was a significant difference in the allele distribution (p = 7.86 × 10−5) and genotype distribution (p = 1.42 × 10−5) of rs6795970 between the AF recurrence and no recurrence groups. In a multivariate analysis, we identified the following independent predictors of AF recurrence: the rs6795970 genotypes in an additive model (OR 0.36, 95%CI 0.22~0.60, p = 7.04 × 10−5), a history of AF ≥36 months (OR 3.57, 95%CI 2.26~5.63, p = 4.33 × 10−8) and left atrial diameter (LAD) ≥40 mm (OR 1.85, 95%CI 1.08~3.19, p = 0.026). These data suggest that genetic variation in SCN10A may play an important role in predicting AF recurrence after catheter ablation in the Chinese Han population.

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Blocking the Pulmonary Vein to Left Atrium Conduction in Addition to the Entrance Block Enhances Clinical Efficacy in Atrial Fibrillation Ablation

Abstract: Unidirectional entrance block with SAs in PVs may not be a good indication of complete PV isolation. Bidirectional block of the PV-LA junction can reduce the acute PV reconnection and may reduce the chronic AF recurrence in patients undergoing circumferential PV isolation.

Cited by 35 publications

References 19 publications

Clinical implications of and factors influencing dissociated pulmonary vein potentials

Clinical implications of and factors influencing dissociated pulmonary vein potentials

Atrial mapping during pulmonary vein pacing: a novel maneuver to detect and close residual conduction gaps in an ablation line

Association of SCN10A Polymorphisms with the Recurrence of Atrial Fibrillation after Catheter Ablation in a Chinese Han Population

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