Radiofrequency ablation of atrial fibrillation in patients with mitral or aortic mechanical prosthetic valves: A feasibility, safety, and efficacy study

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…1262,1263,1264,1265,1266,1267,1268,1396 It results from inadvertent positioning of a circular electrode catheter close to the mitral valve or into the left ventricle, often during attempts to position the catheter into the LIPV or when using such catheters to create electroanatomical maps of the LA. This complication should be suspected when attempts to reposition the catheter into another PV are met with resistance.…”

“…1263,1264,1268,1269,1396 There have also been several cases reported in which the distal tip of the circular catheter broke off during attempts at catheter removal and had to be subsequently removed either with a snare or with an open surgical procedure. 1263,1265,1266 We recommend that if gentle attempts to free the catheter fail, elective surgical removal of the catheter should be performed.…”

Comparison of amiodarone and propafenone for maintenance of stable sinus rhythm after bipolar radiofrequency ablation combined with a mitral valve procedure in patients with mitral valve disease and persistent atrial fibrillation

“…[14] Patients who are cardioverted following mitral valve repair or replacement have a better survival rate as well as freedom from adverse events. [15][16][17] Recently, new methods and devices have been available to facilitate the surgical treatment of AF during mitral valve interventions, and sinus rhythm can now be restored in the majority of patients with persistent AF. Our observations suggest that patients who receive treatment for AF during mitral valve surgery have a better QoL.…”

Catheter Ablation of Paroxysmal Atrial Fibrillation: Have We Achieved Cure with Pulmonary Vein Isolation?

“…34 The reasons underlying the lack of sustained response to PVI are still unclear, although the occurrence of triggers outside the PV region have been shown to play an important role in observational studies. [35][36][37][38][39] Highdose isoproterenol infusion (up to 20 μg/min) together with cardioversion of induced AF is the protocol validated at our institution to provoke latent non-PV triggers. Typically, non-PV triggers cluster in specific regions such as the coronary sinus, the inferior mitral annulus, the interatrial septum particularly at the fossa ovalis/limbus region, the left atrial appendage, 40 the Eustachian ridge, the crista terminalis region, and the superior vena cava.…”