Catheter ablation of atrial fibrillation facilitated by preprocedural three-dimensional transesophageal echocardiography : long-term outcome
- Aim: To evaluate the long-term outcome of catheter ablation of atrial fibrillation (AF) facilitated by preprocedural three-dimensional (3-D) transesophageal echocardiography. Methods: In 50 patients, 3D transesophageal echocardiography (3D TEE) was performed immediately prior to an ablation procedure (paroxysmal AF: 30 patients, persistent AF: 20 patients). The images were available throughout the ablation procedure. Two different ablation strategies were used. In most of the patients with paroxysmal AF, the cryoablation technique was used (Arctic Front Balloon, CryoCath Technologies/Medtronic; group A2). In the other patients, a circumferential pulmonary vein ablation was performed using the CARTO system [Biosense Webster; group A1 (paroxysmal AF), group B (persistent AF)]. Success rates and complication rates were analysed at 4-year follow-up. Results: A 3D TEE could be performed successfully in all patients prior to the ablation procedure and all four pulmonary vein ostia could be evaluated in 84% of patients. The image quality was excellent in the majority of patients and several variations of the pulmonary vein anatomy could be visualized precisely (e.g., common pulmonary vein ostia, accessory pulmonary veins, varying diameter of the left atrial appendage and its distance to the left superior pulmonary vein). All ablation procedures could be performed as planned and almost all pulmonary veins could be isolated successfully. At 48-mo follow-up, 68.0% of all patients were free from an arrhythmia recurrence (group A1: 72.7%, group A2: 73.7%, group B: 60.0%). There were no major complications. Conclusion: 3D TEE provides an excellent overview over the left atrial anatomy prior to AF ablation procedures and these procedures are associated with a favourable long-term outcome.
Author: | Klaus Kettering, Felix Gramley, Ralph Stephan von Bardeleben |
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URN: | urn:nbn:de:hebis:30:3-457705 |
DOI: | https://doi.org/10.4330/wjc.v9.i6.539 |
ISSN: | 1949-8462 |
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/28706589 |
Parent Title (English): | World journal of cardiology |
Publisher: | Baishideng Publ. |
Place of publication: | Hong Kong |
Document Type: | Article |
Language: | English |
Year of Completion: | 2017 |
Date of first Publication: | 2017/06/26 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2018/02/27 |
Tag: | Atrial fibrillation; Catheter ablation; Pulmonary veins; Three-dimensional echocardiography; Transesophageal echocardiography |
Volume: | 9 |
Issue: | 6 |
Page Number: | 13 |
First Page: | 539 |
Last Page: | 546 |
Note: | This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
HeBIS-PPN: | 432159932 |
Institutes: | Medizin / Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (English): | Creative Commons - Namensnennung-Nicht kommerziell 4.0 |