Left Atrial and Pulmonary Vein Ostial Ablation as a New Treatment for Curing Persistent Atrial Fibrillation  Initial Experience and Results

Tada, Hiroshi; Kurosaki, Kenji; Ito, Sachiko; Naito, Shigeto; Yamada, Minoru; Miyaji, Kohei; Hashimoto, Tohru; Yoshimura, Yuko; Nogami, Akihiko; Taniguchi, Koichi

doi:10.1253/circj.69.1057

Cited by 20 publications

(29 citation statements)

References 38 publications

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“…Other studies 27,28 have attached particular importance to the left atrium in the initiation and maintaining of AF and the present study showed that there were aging-associated changes of the electrophysiological properties of the atrial myocardium. In the aged group there was a shorter MAPD90 and ERP of the left atrial myocardium, the shortening ability of the MAPD90 in relation to an increase in the simulation frequency was not maintained in the left atrial myocardium, there were differences between the left and right atrial myocardium, and so on, which we consider would provide the substrate for AF.…”

Section: Discussionsupporting

confidence: 69%

Differences in the Aging-Associated Trends of the Monophasic Action Potential Duration and Effective Refractory Period of the Right and Left Atria of the Rat

Huang

Ding

et al. 2006

Circ J

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SolutionsThe pH of Krebs-Henseleit solution [(mmol/L): NaCl 140, KCl 5.4, MgCl2·5H2O 1.0, CaCl2·2H2O 1.8, glucose 5.0, sodium pyruvate 4.0, tris base 10] was adjusted to 7.4 with HCl, and maintained by equilibration with 5%CO2-95%O2. All reagents were of analytical purity grade. Background The incidence of atrial fibrillation (AF) increases with aging, but the aging-associated electrophysiological changes of atrial myocardium are poorly understood. Methods and ResultsBased on the hypothesis that aging of the atrium enhances AF susceptibility, 30 Wistar rats were divided into 3 age groups: adult, middle-aged, and aged (n=20 per group). Their hearts were isolated and perfused by Langendorff apparatus. Monophasic action potential duration at 90% repolarization (MAPD90) and effective refractory period (ERP) at the basic stimulation cycle length (BCL: 400 ms), and MAPD90 at other different stimulation cycle lengths in each age group were measured. At the BCL, the MAPD90 of the right atrial myocardium was prolonged from the adult to the aged group, that of the left atrial myocardium was prolonged from the adult to middle-aged group, and the MAPD90 of the left atrial myocardium in the aged group were shorter than that in the adult and middle-aged groups. The ERP of the atrial myocardium showed the same ageassociated trend as MAPD90. As the stimulation frequency increased, the MAPD90 of both the left and right atrial myocardium shortened correspondingly in the adult and middle-aged groups, but in the aged group the MAPD90 of the right atrial myocardium shortened markedly more than that of the left atrial myocardium. Conclusions There are different aging-associated electrophysiological changes in the right and left atrium, and the older heart is more vulnerable to developing the substrate for AF. (Circ J 2006; 70: 352 -357)

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Section: Discussionsupporting

confidence: 69%

Differences in the Aging-Associated Trends of the Monophasic Action Potential Duration and Effective Refractory Period of the Right and Left Atria of the Rat

Huang

Ding

et al. 2006

Circ J

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“…11,14 Right femoral venous access was obtained and a multipolar electrode catheter was introduced into the distal coronary sinus. After transseptal catheterization, a 7Fr decapolar ring catheter with 1-mm interelectrode spacing of paired electrodes at intervals of 4.5 or 6.0 mm (Lasso™, Biosense Webster, Diamond Bar, CA, USA) was inserted into the LA and positioned inside the PV within 5 mm of the ostium.…”

Section: Ablation Proceduresmentioning

confidence: 99%

Plasma Natriuretic Peptide Concentrations as a Predictor for Successful Catheter Ablation in Patients With Drug-Refractory Atrial Fibrillation

Kurosaki¹,

Tada

Hashimoto

et al. 2007

Circ J

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“…However, short-term 10-min ECG recordings were sufficient for obtaining representative recordings despite the variability in the magnitude of nonlinear parameters between the long-and short-term R-R interval data. 27 Despite recent achievements in the treatment of AF over the past decade, 30 it still remains as an important cause of morbidity and mortality. The use of nonlinear parameters, such as ApEn, will give new insights into the pathophysiology of AF and its management.…”

Section: Study Limitationsmentioning

confidence: 99%

Prediction of Paroxysmal Atrial Fibrillation Using Nonlinear Analysis of the R-R Interval Dynamics Before the Spontaneous Onset of Atrial Fibrillation

Shin

Yoo²,

et al. 2006

Circ J

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Background New methods based on nonlinear theory have been developed to give more insight into complex heart rate (HR) dynamics. This study was designed to test the hypothesis that altered HR dynamics, as analyzed with complexity and fractal measures, may precede the spontaneous onset of paroxysmal atrial fibrillation (PAF). Secondly, the difference in the temporal change of these measurements between the different types of atrial fibrillation (AF) was assessed. Methods and Results From 105 Holter tapes in which PAF was recorded, 44 PAF (≥5 min) episodes in 33 patients (22 men, 58±12 years), preceded by sinus rhythm for more than 1 h, were selected and submitted to timeand frequency-domain HR variability analyses, along with detrended fluctuation analysis, approximate entropy (ApEn) and sample entropy (SampEn). The 60 min before the onset of AF were divided into 6 10-min periods and studied using repeated measures ANOVA. PAF episodes were divided into 3 subgroups: an increased HF component and decreased L/H ratio (vagal type, n=20); increased L/H ratio and decreased HF component (sympathetic type, n=14); and non-related type (n=10). None of the time-or frequency-domain parameters showed any significant change before AF in any type of AF. The 1 showed a tendency to decrease before the onset of AF and the change in 1 was divergent according to the AF type. The ApEn decreased before the onset of AF (1.005±0.046, 60-50 min before AF to 0.894±0.052, 10-0 min before AF; p=0.032). The SampEn also decreased progressively before the start of AF (1.165± 0.085, 60-50 min before AF to 0.887±0.077, 10-0 min before AF, p=0.003). The decrease in both the ApEn and SampEn was irrespective of the AF type. Conclusions A reduction in the ApEn and SampEn, which reflects the nonlinear complexity of HR variability, is a hallmark of altered HR dynamics preceding the spontaneous onset of AF. (Circ J 2006; 70: 94 -99)

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Left Atrial and Pulmonary Vein Ostial Ablation as a New Treatment for Curing Persistent Atrial Fibrillation Initial Experience and Results

Cited by 20 publications

References 38 publications

Differences in the Aging-Associated Trends of the Monophasic Action Potential Duration and Effective Refractory Period of the Right and Left Atria of the Rat

Differences in the Aging-Associated Trends of the Monophasic Action Potential Duration and Effective Refractory Period of the Right and Left Atria of the Rat

Plasma Natriuretic Peptide Concentrations as a Predictor for Successful Catheter Ablation in Patients With Drug-Refractory Atrial Fibrillation

Prediction of Paroxysmal Atrial Fibrillation Using Nonlinear Analysis of the R-R Interval Dynamics Before the Spontaneous Onset of Atrial Fibrillation

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