Electrophysiological characteristics and catheter ablation of symptomatic focal premature atrial contractions originating from pulmonary veins and non-pulmonary veins.

Abstract

BACKGROUND:

We aimed to explore electrophysiological characteristics of premature atrial contractions (PACs) originating from pulmonary veins (PVs) and non-PVs and to evaluate the effectiveness and safety of catheter ablation for PACs.

HYPOTHESIS:

Symptomatic PACs originated from different positions and whether could be ablated.

METHODS:

Symptomatic, frequent, and drug-refractory PAC patients were enrolled in this study. All patients underwent electrophysiological study and catheter ablation.

RESULTS:

A total of 81 patients were enrolled: 45 patients with PACs originating from PVs (group A), 24 patients with PACs originating from non-PVs (group B), and 12 patients with PACs arising from both PVs and non-PVs (group C). Twenty (44.4%) patients in group A, 6 (50.0%) patients in group C, and 3 (12.5%) patients in group B presented paroxysmal atrial fibrillation (P < 0.05). PV isolation was performed in groups A and C. Focal ablation or superior vena cava isolation was performed in groups B and C, depending on patient condition. PACs were abolished in all patients except one patient in group B. During a median follow-up period of 21.3 ± 14.3 months, 40 (88.9%) patients in group A, 10 (83.3%) patients in group C, and 21 (87.5%) patients in group B were free of recurrence after initial ablation.

CONCLUSIONS:

Frequent PACs originating from PVs were associated with increased incidence of atrial fibrillation compared with PACs originating from non-PVs. Catheter ablation yields a satisfactory success rate and could be a good choice for eliminating symptomatic, frequent, and drug-refractory PACs.

• Authors: Xingfu Huang, Yanjia Chen, Junhui Xiao, Hongxin Zhao, Yizhen Chen, Shenrong Liu, Liwei He, Zheng Huang, Haobin Zhou, Dingli Xu, Jian Peng
• Journal: Clinical cardiology (Clin Cardiol) Vol. 41 Issue 1 Pg. 74-80 (Jan 2018) ISSN: 1932-8737 [Electronic] United States
• PMID: 29369366 (Publication Type: Journal Article)
• Copyright: © 2018 Wiley Periodicals, Inc.

Topics

• Atrial Premature Complexes (diagnosis, physiopathology, surgery)
• Body Surface Potential Mapping (methods)
• Catheter Ablation (methods)
• Electrocardiography, Ambulatory (methods)
• Female
• Follow-Up Studies
• Heart Conduction System (physiopathology, surgery)
• Humans
• Male
• Middle Aged
• Pulmonary Veins
• Retrospective Studies
• Treatment Outcome