Epicardial Atrial Mapping Can Predict Elimination of Chronic Atrial Fibrillation After the Box Pulmonary Vein Isolation During Mitral Valve Surgery

Circulation Journal Volume 76 Issue 4 Page 852-859 published_at 2012
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Title ( eng )
Epicardial Atrial Mapping Can Predict Elimination of Chronic Atrial Fibrillation After the Box Pulmonary Vein Isolation During Mitral Valve Surgery
Creator
Uchida Naomichi
Source Title
Circulation Journal
Volume 76
Issue 4
Start Page 852
End Page 859
Abstract
Background: The pulmonary veins (PV) and posterior left atrium (LA) may contribute to the occurrence and maintenance of atrial fibrillation (AF). We evaluated whether simple epicardial electrophysiological mapping can predict elimination of chronic AF after the box PV isolation procedure.

Methods and Results: Using a computerized 48-channel mapping system, we performed intraoperative atrial mapping in 16 patients with chronic AF associated with mitral valve (MV) disease. Patients' ages ranged from 48 to 76 years (mean, 61.4 years). AF duration ranged from 1 to 16 years (mean, 7.5 +/- 5.4 years). Simple box PV isolation was performed during the MV operation. Regular and repetitive activation was found in the LA of 12 of 16 patients, and irregular and chaotic activation was found in both atria in 4 of 16 patients; 12 patients with regular and repetitive activation of the LA were treated by box PV isolation and the other 4 patients with irregular and chaotic activation in both atria did not recover sinus rhythm after this procedure. AF-free rate was significantly higher in patients with regular and repetitive activation of the LA (P < 0.01).

Conclusions: Box PV isolation was effective in the treatment of chronic AF associated with MV disease. Epicardial atrial mapping may predict elimination of AF after the box PV isolation. (Circ J 2012; 76: 852-859)
Keywords
Atrial fibrillation
Electrophysiological study
Isolation
Pulmonary vein
Surgery
NDC
Medical sciences [ 490 ]
Language
eng
Resource Type journal article
Publisher
Japanese Circulation Society
Date of Issued 2012
Rights
(c) All rights are reserved to the Japanese Circulation Society.
Publish Type Version of Record
Access Rights open access
Source Identifier
[ISSN] 1346-9843
[DOI] 10.1253/circj.CJ-11-0970
[NCID] AA11591968
[DOI] http://dx.doi.org/10.1253/circj.CJ-11-0970