RT Journal Article
T1 Epicardial Connections Between the Pulmonary Veins and Left Atrium: Relevance for Atrial Fibrillation Ablation
A1 Pérez Castellano, Nicasio
A1 Pérez Villacastín Domínguez, Julián
A1 Salinas, Jorge
A1 Vega, Mercedes
A1 Moreno, Javier
A1 Doblado, Manuel
A1 Ruiz, Eduardo
A1 Macaya Miguel, Carlos
AB Epicardial Connections Between PVs and the LA. Introduction: Some observations support the existence of epicardial connections (ECs) between ipsilateral pulmonary veins (vein to vein ECs [VVECs]), and we have observed venoatrial ECs inserted at distance from the pulmonary vein ostium (vein to atrium ECs [VAECs]). Our aim was to determine the prevalence of ECs and their relevance for pulmonary vein isolation.Methods and Results: We studied 100 consecutive patients with drug-refractory atrial fibrillation who underwent ostial pulmonary vein isolation by cooled radiofrequency catheter ablation. A VVEC was identified if pulmonary vein pacing activated the ipsilateral vein before the atrium, requiring ablation of both venous ostia to isolate either pulmonary vein. A VAEC was identified if pacing produced atrial breakthrough located at distance from the venous ostium, requiring extraostial ablation to isolate the pulmonary vein. Patients with ECs (20%) were younger (P = 0.02) and had a higher prevalence of structural heart disease (P = 0.01) than patients without ECs. VVECs and VAECs were identified in 32 pulmonary veins (10%) and VAECs in 10 veins (3%). Veins with ECs had a higher rate of early recurrence of conduction following isolation (29% vs 11%; P = 0.01).Conclusion: Twenty percent of patients with atrial fibrillation had ECs resistant to ostial ablation in one or more pulmonary veins. Isolating veins with ECs may require a different ablation approach. These connections are associated with an increased rate of early recurrence of conduction.
PB Wiley
SN 1045-3873
YR 2011
FD 2011-02-01
LK https://hdl.handle.net/20.500.14352/100838
UL https://hdl.handle.net/20.500.14352/100838
LA eng
NO Pérez-Castellano N, Villacastín J, Salinas J, Vega M, Moreno J, Doblado M, Ruiz E, Macaya C. Epicardial connections between the pulmonary veins and left atrium: relevance for atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2011 Feb;22(2):149-59. doi: 10.1111/j.1540-8167.2010.01873.x. Epub 2010 Aug 30. PMID: 20807282.
DS Docta Complutense
RD 30 sept 2024