Our primary finding is that PVI performed with a wide antral approach is more effective than ostial PVI in achieving freedom from total atrial tachyarrhythmia recurrence at long-term follow-up
BACKGROUND For the past decade , electric pulmonary vein isolation ( PVI ) has become a procedure implemented worldwide for the treatment of atrial fibrillation .
Currently , 2 main approaches are used for PVI : ostial isolation of the PVs and wide antral PVI .
The aims of this systematic review are to evaluate the relative merits of each technique with a pooled comparative analysis of efficacy and complications .
Segmental pulmonary vein antrum isolation using the "large-size" lasso catheter in patients with atrial fibrillation.
BACKGROUND The limited efficacy and complications of segmental ostial pulmonary vein isolation ( PVI ) for treating atrial fibrillation ( AF ) have been discussed so , in the present study the feasibility and efficiency of performing segmental pulmonary vein ( PV ) antrum isolation to treat AF were assessed . METHODS AND RESULTS A total of 187 patients with drug-refractory AF ( paroxysmal 120 , persistent 67 ) underwent segmental PVI guided by circumferential 20-electrode catheters ( Lasso ) . Radiofrequency ( RF ) current was delivered either at the ostium using a regular Lasso ( 15 - 20 mm in diameter , 70 patients : Group 1 ) or at the antrum using a larger Lasso ( 25 - 30 mm in diameter , 117 patients : Group 2 ) . A significantly wider region had to be ablated , with a longer RF application time , to isolate all 4 PVs in Group 2 patients than in Group 1 patients . Although the rate of recurrence of AF after the initial session was equal in both groups , a significantly greater number of patients were free from AF after a mean of 1.4 procedures in Group 2 than in Group 1 ( 93 % vs 76 % for paroxysmal AF , 78 % vs 48 % for persistent AF ) . CONCLUSIONS Segmental antral PVI using large-sized Lasso catheters was found to be more effective and safer than ostial PVI for the treatment of AF
Our primary finding is that PVI performed with a wide antral approach is more effective than ostial PVI in achieving freedom from total atrial tachyarrhythmia recurrence at long-term follow-up
BACKGROUND For the past decade , electric pulmonary vein isolation ( PVI ) has become a procedure implemented worldwide for the treatment of atrial fibrillation .
Currently , 2 main approaches are used for PVI : ostial isolation of the PVs and wide antral PVI .
The aims of this systematic review are to evaluate the relative merits of each technique with a pooled comparative analysis of efficacy and complications .