Abstract
Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline=1∶4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60°C. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132±68 min for our patients. The average fluoroscopy time was 33±17 min. With a mean follow-up of 16±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.
References
Chen, S. A., Hsieh, M. H., Tai, C. T., Tsai, C. F., Prakash, V. S., Yu, W. C. and Hsu, T. L., 1999. Initiation of atrial fibrillation by ectopic beats origination from the pulmonary veins: electrophysiological characteristics, pharmacological responses, and effects of radiofrequency ablation.Circulation,100: 1879–1881.
Haissaguerre, M., Jais, P., Shah, D. C., Takahashi, A., Hocini, M., Quiniou, G., Garrigue, S., Le Mouroux, A., Le Metayer, P. and Clementy, J., 1998. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.N Engl J Med,339: 659–664.
Haissaguerre, M., Jais, P., Shah, D. C., Garrigue, S., Takahashi, A., Lavergne, T., Hocini, M., Peng, J. T., Roudant, R. and Chementy, J., 2000a. Electrophysiological end point for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci.Circulation,101(12): 1409–1417.
Haissaguerre, M., Shah, D. C., Jais, P., Hocini, M., Yamane, T., Deiseihofer, I., Chauvin, M., Garrigue, S. and clementy, J., 2000b. Electrophysiological breakthroughs from the left atrium to the pulmonary veins.Circulation,102(20): 2463–2465.
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Jian-an, W., Yong, S. & Hong, H. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. J. Zheijang Univ.-Sci. 4, 745–748 (2003). https://doi.org/10.1631/BF02851618
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DOI: https://doi.org/10.1631/BF02851618