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Atrial Fibrillation: Role of Arrhythmogenic Foci

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Atrial fibrillation, the most common of all sustained cardiac arrhythmias can be cured by Surgical atriotomies or linear RF catheter ablation. We have investigated the role of focal RF ablation in paroxysmal atrial fibrillation

Methods: sixteen patients with focal atrial fibrillation (extrasystoles, atrial tachycardia and atrial fibrillation due to the same focus firing irregularly at different rates) and 45 with common AF initiated by extrasystolic foci were included. The ablation site was determined on the basis of earliest bipolar activity relative to a stable atrial electrogram reference or to the P wave onset during atrial fibrillation initiation.

Results: All the patients with focal atrial fibrillation were treated with a mean of 5 ± 4 RF applications delivered on a right atrial site (n = 4) or on a pulmonary venous site (n = 13), (one patient had 2 foci). Sixty nine foci (located in the pulmonary veins in 94%) were identified in the 45 patients with common atrial fibrillation initiated by extrasystoles. They were ablated with a mean of 4.5 ± 2 RF applications. Using a mean follow up of 8 ± 6 months, 28/45 (62%) were cured without antiarrhythmic drugs.

Conclusion: Pulmonary veins play an important role in paroxysmal atrial fibrillation. They are the most frequent source of focal atrial fibrillation and of initiating foci amenable to RF ablation.

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Authors and Affiliations

  1. Centre Hospitalies Universitaire de Bordeaux, France

    Pierre Jaïs, Dipen C. Shah, Michel Haïssaguerre, Mélèze Hocini, Stéphane Garrigue & Jacques Clémenty

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  1. Pierre Jaïs
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  2. Dipen C. Shah
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  3. Michel Haïssaguerre
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  4. Mélèze Hocini
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  5. Stéphane Garrigue
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  6. Jacques Clémenty
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Jaïs, P., Shah, D.C., Haïssaguerre, M. et al. Atrial Fibrillation: Role of Arrhythmogenic Foci. J Interv Card Electrophysiol 4 (Suppl 1), 29–37 (2000). https://doi.org/10.1023/A:1009857926782

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