Abstract:
INTRODUCTION:Ablative therapy for atrial fibrillation (AF) by targeting initiating triggers, usually in or around the pulmonary veins, has been reported by several centers. Evidence for an overall improvement in quality of life (QOL) and amelioration of symptoms is lacking. METHODS AND RESULTS:Seventy-one patients undergoing attempted ablation of focal AF were followed for 60+/-33 weeks. QOL and symptom questionnaires were completed 1 month before and 6 months after electrophysiologic study. Twenty-three patients (32%) underwent electrophysiologic mapping but no ablation because of either insufficient or multifocal ectopy; the other 48 patients (68%) underwent attempted ablation. Sixteen of 48 patients (33%) undergoing ablation, or 16 (23%) of 71 on an intention-to-treat basis, were found at last follow-up to have persistent sinus rhythm without antiarrhythmic drugs. Patients who underwent mapping without ablation reported no improvements in any QOL or symptom score, whereas patients who had long-term successful ablation had significant improvements in all six QOL measures. Interestingly, patients who developed AF recurrence after ablation still reported significant improvements in 4 of 6 QOL measures. Four of 48 patients (8.3%) undergoing ablation developed pulmonary vein stenosis. CONCLUSION:Paroxysmal AF can be treated successfully in some patients by ablating initiating triggers in the pulmonary veins; however, in our experience the recurrence rate (32/48 [68%]) and risk of pulmonary vein stenosis (8%) after ablation are high. Patients with recurrent AF after ablation of focal AF triggers have significant improvement in QOL and symptoms compared with before ablation. Patients and their physicians should carefully balance the risks and benefits before considering ablation.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Gerstenfeld EP,Guerra P,Sparks PB,Hattori K,Lesh MDdoi
10.1046/j.1540-8167.2001.00900.xkeywords:
subject
Has Abstractpub_date
2001-08-01 00:00:00pages
900-8issue
8eissn
1045-3873issn
1540-8167journal_volume
12pub_type
杂志文章abstract::After being struck by a car at the age of 7, an otherwise healthy boy developed recalcitrant, albeit hemodynamically, well-tolerated ventricular tachycardia. An electrophysiological study with 3-dimensional electroanatomic mapping was performed under transesophageal echocardiographic guidance at 10 years of age. Nonau...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2010.01928.x
更新日期:2011-06-01 00:00:00
abstract::This article reviews current evidence of non-antiarrhythmic agents for the prevention and maintenance of sinus rhythm in patients with atrial fibrillation. These nontraditional agents include angiotensin converting enzyme inhibitors, angiotensin receptor blockers, antiinflammatory agents, calcium channel blockers, and...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2007.00874.x
更新日期:2007-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14920
更新日期:2021-01-29 00:00:00
abstract:INTRODUCTION:Following radiofrequency catheter ablation of AV nodal reentrant tachycardia (AVNRT), inappropriate sinus tachycardia may occur, possibly due to damage to autonomic cardiac nerve fibers. Furthermore, inducibility of AVNRT is often critically dependent on the autonomic balance. We investigated whether succe...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00936.x
更新日期:1998-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.12482
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Left atrial catheter ablation (LACA) has emerged as a successful method to eliminate atrial fibrillation (AF). Recent reports have described atrio-esophageal fistulas, often resulting in death, from this procedure. Temporary esophageal stenting is an established therapy for malignant esophageal disease. We d...
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pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00464.x
更新日期:2006-04-01 00:00:00
abstract:INTRODUCTION:Gender differences and seasonal variations in cardiac electrophysiology and susceptibility to arrhythmias have been described clinically. The present study was undertaken to determine if there are similar gender and seasonally related differences in the electrophysiology of the rabbit heart. METHODS AND R...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00067.x
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) significantly reduces health-related quality of life (HRQoL), previously measured in clinical trials using patient-reported outcomes (PROs). We examined AF PROs in clinical practice and their association with subsequent clinical management. METHODS:The Utah My Evaluation (mEVAL) pro...
journal_title:Journal of cardiovascular electrophysiology
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更新日期:2020-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2005-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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更新日期:1998-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.13838
更新日期:2019-04-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2009.01610.x
更新日期:2010-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01162.x
更新日期:1994-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2000.01364.x
更新日期:2000-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14523
更新日期:2020-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13823
更新日期:2019-02-01 00:00:00
abstract::Cost-efficacy assessment of implantable cardioverter defibrillator (ICD) therapy has proved contentious and may have limited uptake of ICD therapy, particularly in Europe. Published modeling assessments are too inaccurate to determine clinical practice, and assessments based on clinical studies are incomplete (from th...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2002.tb01964.x
更新日期:2002-01-01 00:00:00
abstract:INTRODUCTION:The objective of this study was to record the ECG of the smallest living mammal to extend the domain of data for comparative AV nodal electrophysiologic purposes. These data are needed to establish the relationship between the PR interval and heart size in mammalian species of all sizes. METHODS AND RESUL...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00658.x
更新日期:1999-02-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2005.50127.x
更新日期:2005-09-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,meta分析,评审
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更新日期:2003-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1540-8167.1994.tb01116.x
更新日期:1994-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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更新日期:2004-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.04440.x
更新日期:2004-12-01 00:00:00
abstract::It has been demonstrated that idiopathic ventricular fibrillation (VF) can be triggered by ventricular premature beats (VPBs) arising from the Purkinje fibers. Eliminating these VPBs by radiofrequency catheter ablation prevented VF recurrences. Whether the same pathophysiology and the same treatment option exist in pa...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.03386.x
更新日期:2004-01-01 00:00:00
abstract::A patient with congenital complete heart block underwent implantation of a dual-chamber pacemaker. He presented to the emergency room with fatigue and was found to be in atrial flutter. Device interrogation revealed undersensing of 5 mV flutter waves at a programmed sensitivity of 0.5 mV. Due to undersensing, mode swi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00571.x
更新日期:2006-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00349.x
更新日期:2001-03-01 00:00:00
abstract::The cavotricuspid isthmus (CVTI) is the well-established location of atrial tissue critical for the maintenance of typical atrial flutter. The CVTI begins at the electrically inert tricuspid valve and includes the atrial myocardium up to the inferior vena cava (IVC). In this article, we discuss relevant CVTI and right...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/j.1540-8167.2008.01344.x
更新日期:2009-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14186
更新日期:2019-11-01 00:00:00
abstract::A novel application of the Biosense CARTO System anatomic electromagnetic voltage mapping is presented, utilized as a guide for permanent pacemaker placement. The technique is illustrated in the successful implantation of an atrial lead in a patient with Ebstein's anomaly characterized by a severely dilated right atri...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00744.x
更新日期:2000-01-01 00:00:00