Tachycardia transition during ablation of persistent atrial fibrillation.

Background: The "sequential ablation" strategy for persistent AF is aimed at progressive organization of AF until the rhythm converts to sinus rhythm or atrial tachycardia (AT). During ablation of an AT, apparently seamless transitions from one organized AT to another occur. The purpose of our study was to quantify the occurrence and the mechanism of this transition.

Peri-mitral atrial flutter in patients with atrial fibrillation ablation.

Background: Peri-mitral atrial flutter (PMFL) is commonly encountered in patients undergoing atrial fibrillation (AF) ablation.

Objective: The purpose of this study was to determine the electrophysiologic characteristics, procedural success, and medium-term outcomes in patients with PMFL.

Methods: The study consisted of 50 consecutive patients (45 men and 5 women, age 57 +/- 12 years) with PMFL following or during AF ablation.

Clinical predictors of termination and clinical outcome of catheter ablation for persistent atrial fibrillation.

Objectives: This study evaluated the role of pre-procedural clinical variables to predict procedural and clinical outcomes of catheter ablation in patients with long-lasting persistent atrial fibrillation (AF).

Background: Catheter ablation of persistent AF remains a challenging task.

Methods: Catheter ablation was performed in 90 patients (76 men, age 57 +/- 11 years) with long-lasting persistent AF.

Long-term follow-up of persistent atrial fibrillation ablation using termination as a procedural endpoint.

Aims: Catheter ablation of long-lasting persistent atrial fibrillation (AF) has been performed with varying results using a combination of different techniques. Whether arrhythmia termination during ablation is associated with an improved clinical outcome is controversial.

Methods And Results: In this prospective study, 153 consecutive patients (56 +/- 10 years) underwent catheter ablation of persistent AF (25 +/- 33 months) using a stepwise approach with the desired procedural endpoint being AF termination.

Dual independent atrial tachycardias after ablation of chronic atrial fibrillation.

We report the case of a 71-year-old man with two atrial tachycardias evolving simultaneously and independently in two dissociated regions after extensive ablation for chronic atrial fibrillation. One tachycardia was a focal tachycardia originating from the right inferior pulmonary vein and activating the posterior left atrium with a 2:1 conduction block, while the other tachycardia was an atrial flutter circulating around the tricuspid annulus, activating the right atrium and the anterior wall of the left atrium. These two atrial tachycardias were successfully ablated prior to restoration of sinus rhythm.

Cycle length dependent block in the "mitral-pulmonary vein" isthmus.

We report a case of cycle length dependent activation sequence in the coronary sinus catheter during assessment of mitral-pulmonary vein isthmus block. A 61-year-old patient presented with atrial tachycardia following a recent pulmonary vein isolation for paroxysmal atrial fibrillation. A perimitral macroreentrant atrial tachycardia was demonstrated during mapping.

Focal arrhythmia confined within the coronary sinus and maintaining atrial fibrillation.

Introduction: The coronary sinus (CS) is a complex structure comprising a mesh of circumferential muscular fibers with oblique connections to both atria. We describe further evidence for the clinical importance of CS arrhythmogenicity in maintaining atrial fibrillation (AF) in humans.

Methods: Since January 2004, following a sequential approach, the CS and the inferior left atrium were ablated in 144 patients with symptomatic drug refractory AF.

Catheter ablation of persistent and permanent atrial fibrillation: Bordeaux experience.

The seminal observation that ectopics from the pulmonary veins may initiate paroxysmal atrial fibrillation (AF) heralded an era of potentially curative catheter ablation therapy for AF. In recent years, catheter ablation has been performed for not only paroxysmal but also persistent and permanent AF. It is anticipated that the number of procedures will continue to increase and the indication for catheter ablation will expand.

Impact of catheter ablation of the coronary sinus on paroxysmal or persistent atrial fibrillation.

Objectives: This study evaluated the impact of catheter ablation of the coronary sinus (CS) region during paroxysmal and persistent atrial fibrillation (AF).

Background: The CS musculature and connections have been implicated in the genesis of atrial arrhythmias.

Methods: Forty-five patients undergoing catheter ablation of AF were studied.

Contribution of the electrophysiological and anatomical analysis of the atypical atrioventricular nodal tachycardia circuit.

Objectives: To analyze retrograde conduction during junctional ectopic tachycardia (JET) episodes and investigate the existence of a relationship between the presence of a retrograde block and the risk of atrioventricular block (AVB) development during radiofrequency ablation procedures in patients with nodal atrioventricular tachycardia (NAVT).

Methods: 145 male and female patients aged 16-84 years, with NAVT who had undergone radiofrequency catheter ablation in the posteroseptal region of the right atrium were studied. Evaluation criteria were anatomical location and electrophysiological behavior of retrograde conduction during NAVT, in order to understand the nodal reentrant circuit (classifying the tachycardia as typical or atypical), and monitoring of retrograde conduction during JET episodes for risk-predicting AVB events.