Resumption of electrical conduction in previously isolated pulmonary veins - Rationale for a different strategy?
Resumption of electrical conduction in previously isolated pulmonary veins - Rationale for a different strategy?
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DOI：
10.1161/01.cir.0000121423.78120.49
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发表时间：
2004-03-16
期刊：
影响因子：
37.8
通讯作者：
Kay, GN
中科院分区：
文献类型：
--
作者：
Nanthakumar, K;Plumb, VJ;Kay, GN
背景-肺静脉电隔离术（PVI）后房颤（AF）可能复发，原因可能是肺静脉传导复发或非肺静脉病灶。本研究的特点是电生理结果与复发性房颤患者后，最初成功的肺静脉隔离和临床结果后，重复procedure.Methods和结果-在185例接受肺静脉隔离，52例报告没有显着改善他们的临床过程。我们分析了重复肺静脉隔离时51条肺静脉（15例患者）的肺静脉传导。用射频（30 W，50 ℃，60秒）或冷冻消融（-80 ℃，5分钟）隔离所有肺静脉。在重复研究中，先前隔离的51条肺静脉中有42条恢复传导。所有患者均在大于或等于2个肺静脉中出现复发性传导，仅发现1个非肺静脉病灶。与初始手术相比，重复手术时重新隔离肺静脉所需的平均射频应用次数较少（10 +/- 6 vs 4 +/- 2，P
Background - Atrial fibrillation (AF) may recur after pulmonary vein isolation (PVI) as the result of either recurrent PV conduction or non-PV foci. This study characterized the electrophysiological findings of patients with recurrent AF after initially successful PVI and the clinical outcome after a repeat procedure.Methods and Results - Among 185 patients undergoing PVI, 52 reported no significant improvement in their clinical course. We analyzed PV conduction in 51 PVs ( 15 patients) at repeat PVI. All PVs were isolated with either RF (30 W, 50 degreesC, 60 seconds) or cryoablation (-80 degreesC for 5 minutes). At repeat study, 42 of the previously isolated 51 PVs had return of conduction. All patients had recurrent conduction in greater than or equal to 2 PVs, with only 1 non-PV focus identified. The mean number of RF applications required to re-isolate the PVs was fewer at the repeat compared with the initial procedure (10 +/- 6 versus 4 +/- 2, P