Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy

Circulation. 2003 Jul 1;107(25):3176-83. doi: 10.1161/01.CIR.0000074206.52056.2D. Epub 2003 Jun 23.

Abstract

Background: Most of the ectopic beats initiating paroxysmal atrial fibrillation (PAF) originate from the pulmonary vein (PV). However, only limited data are available on PAF originating from the non-PV areas.

Methods and results: Two hundred forty patients with a total of 358 ectopic foci initiating PAF were included. Sixty-eight (28%) patients had AF initiated by ectopic beats (73 foci, 20%) from the non-PV areas, including the left atrial posterior free wall (28, 38.3%), superior vena cava (27, 37.0%), crista terminalis (10, 3.7%), ligament of Marshall (6, 8.2%), coronary sinus ostium (1, 1.4%), and interatrial septum (1, 1.4%). Catheter ablation eliminated AF with acute success rates of 63%, 96%, 100%, 50%, 100%, and 0% in left atrial posterior free wall, superior vena cava, crista terminalis, ligament of Marshall, coronary sinus ostium, and interatrial septum, respectively. During a follow-up period of 22+/-11 months, 43 patients (63.2%) were free of antiarrhythmic drugs without AF recurrence.

Conclusions: Ectopic beats initiating PAF can originate from the non-PV areas, and catheter ablation of the non-PV ectopy has a moderate efficacy in treatment of PAF.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Atrial Fibrillation / etiology
  • Atrial Fibrillation / physiopathology*
  • Atrial Fibrillation / surgery*
  • Cardiac Complexes, Premature / complications
  • Cardiac Complexes, Premature / physiopathology*
  • Cardiac Complexes, Premature / surgery
  • Catheter Ablation*
  • Disease-Free Survival
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Follow-Up Studies
  • Heart Atria / physiopathology
  • Heart Atria / surgery
  • Heart Diseases / complications
  • Heart Diseases / physiopathology
  • Heart Septum / physiopathology
  • Heart Septum / surgery
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Veins*
  • Treatment Outcome
  • Vena Cava, Superior / physiopathology
  • Vena Cava, Superior / surgery