Objective: To investigate the feasibility and efficacy of treating atrial fibrillation (AF) with circumferential pulmonary vein (PV) linear ablation guided by 3 dimensional mapping system and single circular mapping catheter.
Methods: From April 2004 to January 2005, PV isolation with circumferential PV linear ablation guided by CARTO system (in 76 patients) or EnSite-NavX system (in 24 patients) was performed in 100 consecutive patients with significantly symptomatic, drug refractory AF. The procedural end-point was complete electrical isolation of bilateral PV.
Results: Up to 200 linear circles were produced around each ipsilateral PVs in all 100 cases, and 95.0% (190/200) of PV isolation rate was achieved with a mean procedure time of 150-365 (240 +/- 65) min and a mean fluoroscopy time of 23-61 (37 +/- 12) min, respectively. Eight cases with recurrent AF (8.0%) underwent second session. Cumulative atrial tachyarrhythmias-free rate was 85.0% (85/100) during a mean follow-up of 5.5-12 (10.2 +/- 5.7) months. Atrial tachyarrhythmias-free rate was 66.0% (66/100), 82.0% (82/100), 87.0% (87/100), 85.0% (85/100), 85.0% (85/100), and 88.6% (70/79) during the follow up at 1 month, 2 months, 3 months, 4 months, 5 months and 6 months, respectively. There were 2 complications (1 tamponade and 1 PV stenosis), which were rehabilitated after conservative treatment.
Conclusion: PV isolation with circumferential PV linear ablation guided by 3 dimensional mapping system is safe and effective for treating AF.