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Comparation of the efficacy between pulmonary vein antral isolation plus high density left atrial voltage mapping and pulmonary vein isolation on paroxysmal atrial fibrillation

This study aims to discuss the efficacy between Pulmonary Vein Antral Isolation (PVAI) plus High Density Left Atrial Voltage Mapping (HDVM) and pulmonary vein isolation on Paroxysmal Atrial Fibrillation (PAF). A total of 60 patients with paroxysmal atrial fibrillation underwent radioablation in our department from January 2012 to January 2014; all cases were divided into two groups: 30 patients in group A (PVAI), 30 patients in group B (PVAI+HDVM). Atrial arrthymic data including atrial premature, atrial tachycardia, atrial flutter, and atrial fibrillation were collected by routine Electrocardiogram (ECG) and 24 h-Holter every month during 1-year post-operation follow-ups. Ablation recurrence was defined as any atrial arrthymic events (atrial tachycardia, atrial flutter, atrial fibrillation) persisting for more than 30 seconds by real-time ECG record and/or 24 h-Holter 3-month after ablation. 60 cases of PVAI were operated successfully. Low-Voltage Zones (LVZs) were located on right superior pulmonary vein outside antrum in 7 cases, right inferior pulmonary vein outside in 3 cases, left anterosuperior wall in 6 cases, left anteroinferior wall in 9 cases, roof in 3 cases, upperposterior wall in 2 cases. 1-year atrial fibrillation ablation success rate were at the same level (83.3% vs. 80.0%, P>0.05). No difference were found in 3-month atrial arrthymic recurrences between two groups statistically (43.1% vs. 40.7% at 1st month, 20.7% vs. 21.3% at 2nd month, 21.3% vs. 20.2% at 3rd month, P>0.05). Combination of pulmonary vein isolation with high density left atrial voltage mapping cannot improve ablation success rate of paroxysmal atrial fibrillation and increase the recurrence of atrial arrthymias.

Author(s): Yangbo Xing, Fangfang Yang, Hangyuan Guo, Chao Xu, Zhansheng Xiao, Fang Peng, Yufang Qiu