Choosing the Proper Candidate and Technique for Atrial Fibrillation Ablation

2010 ◽  
Vol 6 (4) ◽  
pp. 74
Author(s):  
Dipen Shah ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Rate Control ◽  
Left Atrial ◽  
Disease Duration ◽  
Control Strategies ◽  
Atrial Fibrosis ◽  
Atrial Myocardium ◽  
Atrial Size ◽  
Left Atrial Fibrosis

The increasing popularity of catheter ablation for atrial fibrillation has been associated with a variety of techniques and ablation strategies as well as widening indications. A critical analysis of outcomes after catheter ablation is necessary to discern those patients unlikely to benefit from catheter ablation in order to propose rate control strategies with confidence. Left atrial size, advanced age, long standing mitral valve disease, duration of atrial fibrillation as well as left atrial fibrosis are currently thought to be important parameters associated with poorer outcomes. Determining the best suited ablation techniques from amongst different strategies of pulmonary vein (PV) isolation, atrial and coronary sinus ablation for specific subgroups of patients may avoid unnecessary ablation and preserve contractile atrial myocardium.

scholarly journals Impact of left atrial fibrosis and left atrial size on the outcome of catheter ablation for atrial fibrillation

Heart ◽  
2011 ◽  
Vol 97 (22) ◽  
pp. 1847-1851 ◽  
Author(s):  
D. W. den Uijl ◽  
V. Delgado ◽  
M. Bertini ◽  
L. F. Tops ◽  
S. A. Trines ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Left Atrial Size ◽  
Atrial Fibrosis ◽  
Atrial Size ◽  
Left Atrial Fibrosis

scholarly journals The Effect of Catheter Ablation on Left Atrial Size and Function for Patients with Atrial Fibrillation: An Updated Meta-Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0129274 ◽  
Author(s):  
Bin Xiong ◽  
Dan Li ◽  
Jianling Wang ◽  
Laxman Gyawali ◽  
Jinjin Jing ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Meta Analysis ◽  
Left Atrial Size ◽  
Atrial Size ◽  
And Function

scholarly journals The Association of Pre-Existing Left Atrial Fibrosis with Clinical Variables in Patients Referred for Catheter Ablation of Atrial Fibrillation

2014 ◽  
Vol 8s1 ◽  
pp. CMC.S15036 ◽  
Author(s):  
Jane Dewire ◽  
Irfan M. Khurram ◽  
Farhad Pashakhanloo ◽  
David Spragg ◽  
Joseph E. Marine ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Af Ablation ◽  
Group 4 ◽  
Significant Difference ◽  
History Of ◽  
Group 2 ◽  
Magnetic Resonance Imaging Mri ◽  
Left Atrial Fibrosis

Introduction Atrial fibrillation (AF) recurrence after ablation is associated with left atrial (LA) fibrosis on late gadolinium enhanced (LGE) magnetic resonance imaging (MRI). We sought to determine pre-ablation, clinical characteristics that associate with the extent of LA fibrosis in patients undergoing catheter ablation for AF. Methods and Results Consecutive patients presenting for catheter ablation of AF were enrolled and underwent LGE-MRI prior to initial AF ablation. The extent of fibrosis as a percentage of total LA myocardium was calculated in all patients prior to ablation. The cohort was divided into quartiles based on the percentage of fibrosis. Of 60 patients enrolled in the cohort, 13 had <5% fibrosis (Group 1), 15 had 5-7% fibrosis (Group 2), 17 had 8-13% fibrosis (Group 3), and 15 had 14-36% fibrosis (Group 4). The extent of LA fibrosis was positively associated with time in continuous AF, and the presence of persistent or longstanding persistent AF. However, no statistically significant difference was observed in the presence of comorbid conditions, age, BMI, LA volume, or family history of AF among the four groups. After adjusting for diabetes and hypertension in a multivariable linear regression model, paroxysmal AF remained independently and negatively associated with the extent of fibrosis (-4.0 ± 1.8, P = 0.034). Conclusion The extent of LA fibrosis in patients undergoing AF ablation is associated with AF type and time in continuous AF. Our results suggest that the presence and duration of AF are primary determinants of increased atrial LGE.

scholarly journals Voltage mapping as a method of left atrial fibrosis evaluation

2016 ◽  
Vol 20 (2) ◽  
pp. 111 ◽  
Author(s):  
O. V. Sapelnikov ◽  
Yu. A. Shuvalova ◽  
D. Yu. Cherkashin ◽  
A. A. Krupnov ◽  
A. S. Partigulova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Large Scale ◽  
Atrial Fibrosis ◽  
Instrumental Data ◽  
Voltage Mapping ◽  
Special Software ◽  
Mechanisms Of Development ◽  
Left Atrial Fibrosis ◽  
And Control

<p><strong>Aim:</strong> This pilot study is designed to better understand the mechanisms of development and control of atrial fibrillation.<br /><strong>Methods:</strong> The correlation between fibrosis index (FI), which was calculated intraoperatively with special software, and clinical and instrumental data was analyzed. Also evaluated were FI values as compared to AF catheter ablation outcomes. <br /><strong>Results:</strong> Voltage mapping may be considered as a possible alternative to MRI examination and in some cases it is more informative. <br /><strong>Conclusion:</strong> It was found out that the preliminary results received are a good start for planning a large-scale study in this area related to assessment of the predicative and practical value of the fibrosis index.</p>

scholarly journals ECHOCARDIOGRAPHIC MARKERS OF LEFT ATRIAL FIBROSIS ASSOCIATED WITH THE SEVERITY OF ATRIAL FIBRILLATION

2016 ◽  
Vol 67 (13) ◽  
pp. 1809 ◽  
Author(s):  
Melissa Leung ◽  
Rachid Abou ◽  
Philippe Van Rosendael ◽  
Suzanne Van Wijngaarden ◽  
Madelien Regeer ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Atrial Fibrosis ◽  
Left Atrial Fibrosis
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