Incidence, location, and cause of recovery of electrical connections between the pulmonary veins and the left atrium after pulmonary vein isolation

Takumi Yamada, Yoshimasa Murakami, Taro Okada, Mitsuhiro Okamoto, Takeshi Shimizu, Junji Toyama, Yukihiko Yoshida, Naoya Tsuboi, Teruo Ito, Masahiro Muto, Takahisa Kondo, Yasuya Inden, Makoto Hirai, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Aims: The aim of this study was to reveal the incidence, location, and cause of recovery of the electrical connections (ECs) between the left atrium and the pulmonary veins (PVs) after the segmental ostial PV isolation (PVI). Methods and results: Pulmonary vein mapping and successful PVI were performed using a computerized three-dimensional mapping system (QMS2™) with a basket catheter in 167 PVs in 53 consecutive patients with atrial fibrillation (AF). In 14 patients with recurrent AF after PVI, the same PV mapping and isolation as in the first procedure were performed, and the PV potential maps constructed by QMS2 in two different procedures were compared. Forty-nine recovered ECs were observed in 27 PVs, and all were eliminated by a few local radiofrequency (RF) applications. Thirty-four (69%) of those ECs recovered at the edge of original ECs, and another 15 (31%) recovered at the mid-portion of the continuous broad original ECs. Conclusion: Electrical connection recovery occurred most commonly at the edges of original ECs and occasionally at the mid-portion of continuous broad original ECs after PVI probably due to tissue oedema neighbouring the segmental RF lesions. Further RF lesions at the edge of original ECs and linear ablation to the continuous broad ECs may help reduce AF recurrence.

Original languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalEuropace
Volume8
Issue number3
DOIs
StatePublished - Mar 2006
Externally publishedYes

Keywords

  • Atrial fibrillation
  • Multielectrode basket catheter
  • Pulmonary veins
  • Radiofrequency catheter ablation
  • Three-dimensional potential mapping

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