Chang SL |
------>authors3_c= ------>paper_class1=1 ------>Impact_Factor=11.054 ------>paper_class3=2 ------>paper_class2=1 ------>vol=50 ------>confirm_bywho=yjchen ------>insert_bywho=yjchen ------>Jurnal_Rank=2.7 ------>authors4_c= ------>comm_author= ------>patent_EDate=None ------>authors5_c= ------>publish_day=4 ------>paper_class2Letter=None ------>page2=973 ------>medlineContent= ------>unit=E1400 ------>insert_date=20081224 ------>iam=7 ------>update_date=None ------>author=??? ------>change_event=4 ------>ISSN=0735-1097 ------>authors_c= ------>score=500 ------>journal_name=J Am Coll Cardiol ------>paper_name=The role of left atrial muscular bundles in catheter ablation of atrial fibrillation. ------>confirm_date=20090501 ------>tch_id=087031 ------>pmid=17765124 ------>page1=964 ------>fullAbstract=OBJECTIVES: We sought to investigate the imaging of the left atrial (LA) muscular bundle and the relationship between the bundle and inducibility of tachyarrhythmia after pulmonary vein isolation (PVI). BACKGROUND: Noninducibility is used as a clinical end point of atrial substrate ablation after PVI. However, little is known about the role of the LA muscular bundles in tachyarrhythmia after PVI. METHODS: Forty-three consecutive patients with paroxysmal atrial fibrillation who underwent catheter ablation were included. Bi-atrial isochronal mapping was performed with the NavX system (St. Jude Medical Inc., St. Paul, Minnesota) during sinus rhythm. After 4 PVI, inducible organized LA flutter with or without transforming to atrial fibrillation (AF) (LA flutter/AF) was ablated with additional lines at the roof and/or mitral isthmus. RESULTS: The existence of bilateral muscular bundles was an independent predictor of LA flutter/AF after PVI (p = 0.02). Patients with LA flutter/AF after PVI had a greater index of the double potentials (5.4 +/- 3.4% vs. 2.8 +/- 1.8%, p = 0.006) and interpotential interval (33 +/- 5 ms vs. 29 +/- 4 ms, p = 0.02) than without LA flutter/AF. The muscular bundles were identified in 28% patients using 16-slice multidetector computed tomography, which were identical to the isochrone map. Patients with noninducible LA flutter/AF after PVI plus the additional linear ablation had a lower recurrence rate as compared with the patients without it (19% vs. 75%, p = 0.02). CONCLUSIONS: Left atrial muscular bundles may provide a conduction block line and barrier, which is important for the formation of LA flutter/AF after PVI. The noninducibility of LA flutter/AF achieved after additional linear ablation may contribute to a better outcome in RF ablation of paroxysmal atrial fibrillation. ------>tmu_sno=None ------>sno=21030 ------>authors2=Tai CT ------>authors3=Lin YJ ------>authors4=Wongcharoen W ------>authors5=Lo LW ------>authors6=Lee KT, Chang SH, Tuan TC, Chen YJ, Hsieh MH, Tsao HM, Wu MH, Sheu MH, Chang CY, Chen SA. ------>authors6_c= ------>authors=Chang SL ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c= ------>publish_area=0 ------>updateTitle=The role of left atrial muscular bundles in catheter ablation of atrial fibrillation. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no=10 ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2007 ------>submit_flag=None ------>publish_month=9 |