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The Linear Ablation of Atrial Fibrillation in the Right Atrium: Can the Isthmus Ablation Improve Its Efficacy?

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Abstract

Objectives: The aims of this study were to compare the efficacy of a 2- versus a 3 RF lesions ablation procedure in the RA in patients with paroxysmal AF, and to map right atrial activation during AF.

Background: RF catheter-mediated ablation lines mimicking the Maze operation have been proposed as a novel curative approach for AF. The relationship between this type of ablation and right atrial mapping has not been extensively studied.

Methods: Twenty-four patients with recurrent, drug-refractory, paroxysmal AF underwent an extensive mapping of the RA before attempting linear lesion RF ablation. Patients were divided into two groups: 15 patients received two linear lesions (Group 1), 9 patients three linear lesions (Group 2).

Results: One-month success rate AF did not recur in 40% of Group 1 patients (6/15) and in 66% (6/9) of Group 2 patients. 27% of patients in Group 1 and 11% of patients in Group 2 had recurrences controlled by drugs. No benefit in 33% of Group 1 patients and 22% of Group 2.

Long-term follow-up In the absence of any drug treatment, no AF recurrences were observed in 26% of Group 1 patients (FU: 23 to 47 months) and 55% of Group 2 (FU: 14 to 23 months). No complications were reported.

Conclusions: Right atrial linear ablation is safe and may be proposed for AF treatment in selected patients.

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Authors and Affiliations

  1. Divisione di Cardiologia, Policlinico Multimedica, Sesto S.Giovanni, (MI)

    Annibale Sandro Montenero, Pasquale Franciosa, Francesco Zumbo, Andrea Antonelli & Daniele Mangiameli

  2. Unita' Operativa di Cardiologia, Azienda Ospedaliera Santa Maria, Terni, Italy

    Michèle Adam

  3. Istituto Superiore di Sanità, Rome, Italy

    Pietro Bartolini & Vincenzo Barbaro

  4. Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy

    Fulvio Bellocci & Attilio Maseri

Authors
  1. Annibale Sandro Montenero
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  2. Michèle Adam
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  3. Pasquale Franciosa
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  4. Francesco Zumbo
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  5. Andrea Antonelli
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  6. Daniele Mangiameli
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  7. Pietro Bartolini
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  8. Vincenzo Barbaro
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  9. Fulvio Bellocci
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  10. Paolo Zecchi
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  11. Attilio Maseri
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Correspondence to Annibale Sandro Montenero.

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Montenero, A.S., Adam, M., Franciosa, P. et al. The Linear Ablation of Atrial Fibrillation in the Right Atrium: Can the Isthmus Ablation Improve Its Efficacy?. J Interv Card Electrophysiol 6, 251–265 (2002). https://doi.org/10.1023/A:1019513904900

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  • DOI: https://doi.org/10.1023/A:1019513904900

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