This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Calkins, H. Search for Related Content PubMed PubMed Citation Articles by Calkins, H. Related Collections Ablation/ICD/surgery Other Treatment Related Article

Editorials

Further Insight into the Technique and Outcomes of "Curative" Catheter Ablation of Atrial Fibrillation

Hugh Calkins, MD

From Johns Hopkins Hospital, Baltimore, Md.

Correspondence to Hugh Calkins, MD, Johns Hopkins Hospital, 530 Carnegie, 600 North Wolfe Street, Baltimore, MD 21287-6568. Email: hcalkins@jhmi.edu

Key Words: ablation • arrhythmia • catheter ablation • tachyarrhythmias • atrial fibrillation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

During the past decade, catheter ablation of atrial fibrillation (AF) has emerged as an important treatment option for patients with symptomatic AF refractory to 1 antiarrhythmic agents. Electric isolation of the pulmonary vein musculature (PVI) has been identified as the primary end point for both catheter- and surgical-based AF ablation procedures.¹ What is less clear is whether the addition of "linear lesions" or ablation of atrial sites demonstrating complex atrial electrograms improves outcome for patients with paroxysmal, persistent, or long-standing persistent AF.^2,3 This issue remains an area of active discussion, debate, and investigation.

Article see p 269

In this issue of Circulation: Arrhythmia and Electrophysiology, Gaita et al² report the results of a prospective single-center randomized study of 204 patients who underwent catheter ablation for treatment of paroxysmal or persistent/permanent AF. Patients were stratified according to whether they had paroxysmal (n=125) or persistent/permanent (n=79) AF and were then randomized in a 2:1 fashion to undergo PVI alone or PVI combined with a "roof line" and a "left mitral line." Follow-up visits that included an ECG, 24-hour Holter, and an echocardiogram were set up at 1, 3, 6, 12, 18, 24, and 30 months and then every year thereafter. If a patient experienced symptoms between follow-up visits, an event monitor was prescribed. A recurrence was defined as a symptomatic or asymptomatic episode of AF or atrial flutter lasting 30 seconds after a 2-month blanking period. Patients who developed a recurrence after the blanking period were offered a repeat ablation procedure. . . . [Full Text of this Article]

Related Article

Long-Term Clinical Results of 2 Different Ablation Strategies in Patients With Paroxysmal and Persistent Atrial Fibrillation

Fiorenzo Gaita, Domenico Caponi, Marco Scaglione, Antonio Montefusco, Antonella Corleto, Fernando Di Monte, Daniele Coin, Paolo Di Donna, and Carla Giustetto
Circ Arrhythm Electrophysiol 2008 1: 269-275. [Abstract] [Full Text] [PDF]