scholarly journals Long-standing Persistent Atrial Fibrillation Ablation: the Role of the Inter- and Intra-atrial Bundles

2020 ◽  
Vol 33 (2) ◽  
pp. 73-81
Author(s):  
Russell Mitchell ◽  
Cesar Augusto Bonilla Isaza
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Clinical Outcomes ◽  
Pulmonary Veins ◽  
Persistent Atrial Fibrillation ◽  
Conduction System ◽  
Atrial Fibrillation Ablation ◽  
Anatomical Location

Catheter ablation has become the mainstream treatment of atrial fibrillation, but still remains a challenge in those patient with persistent and long standing persistent atrial fibrillation. In addition of isolation of the pulmonary veins, any other areas that can trigger or perpetuate atrial fibrillation need to be isolated. Current technologies may allow to effectively deliver permanently lasting lesions, and therefore improve clinical outcomes after ablation. The specialized conduction system including the Bachmann and septopulmonary bundles, are important substrate targets for the management of atrial fibrillation. The anatomical location of these fibers, and the corresponding approach for ablation are described in this case.

Biomarkers Determining Prognosis of Atrial Fibrillation Ablation

2019 ◽  
Vol 26 (5) ◽  
pp. 925-937 ◽  
Author(s):  
Dimitris Tsiachris ◽  
George Giannopoulos ◽  
Spyridon Deftereos ◽  
Charis Kossyvakis ◽  
Constantinos Tsioufis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Inflammatory Markers ◽  
Persistent Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
Oxidative Stress Biomarkers ◽  
Specific Patient ◽  
Term Administration ◽  
The Impact

Catheter ablation for rhythm control is recommended in specific patient populations with paroxysmal, persistent, or long-standing persistent atrial fibrillation. Pulmonary vein isolation is the cornerstone of the ablative therapy for atrial fibrillation. However, relapse is still common since the single procedure efficacy of atrial fibrillation ablation was estimated to be 60-80% in paroxysmal and 50-70% in persistent atrial fibrillation. It is important to identify predictors of successful atrial fibrillation patients ablation. In the present review, we will assess the role of available biomarkers to predict responders of an initial atrial fibrillation catheter ablation. Emphasis has been given on the role of myocardial injury biomarkers, natriuretic peptides and traditional inflammatory markers. Novel inflammatory markers, oxidative stress biomarkers and microRNAs have also been examined as predictors of a successful atrial fibrillation procedure. Notably, the impact of procedural and short-term administration of steroids, as well as the role of colchicine on preventing atrial fibrillation recurrence after ablation is thoroughly presented.

Role of Pulmonary Veins Isolation in Persistent Atrial Fibrillation Ablation:

2009 ◽  
Vol 32 ◽  
pp. S116-S119 ◽  
Author(s):  
GIUSEPPE STABILE ◽  
EMANUELE BERTAGLIA ◽  
PIETRO TURCO ◽  
FRANCO ZOPPO ◽  
ASSUNTA IULIANO ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Persistent Atrial Fibrillation ◽  
Atrial Fibrillation Ablation

scholarly journals Persistent Atrial Fibrillation: The Role of Left Atrial Posterior Wall Isolation and Ablation Strategies

2021 ◽  
Vol 10 (14) ◽  
pp. 3129
Author(s):  
Riyaz A. Kaba ◽  
Aziz Momin ◽  
John Camm
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Pulmonary Veins ◽  
Treatment Strategies ◽  
Persistent Atrial Fibrillation ◽  
Posterior Wall ◽  
Cardiovascular Death ◽  
Good Effect ◽  
Complex Forms

Atrial fibrillation (AF) is a global disease with rapidly rising incidence and prevalence. It is associated with a higher risk of stroke, dementia, cognitive decline, sudden and cardiovascular death, heart failure and impairment in quality of life. The disease is a major burden on the healthcare system. Paroxysmal AF is typically managed with medications or endocardial catheter ablation to good effect. However, a large proportion of patients with AF have persistent or long-standing persistent AF, which are more complex forms of the condition and thus more difficult to treat. This is in part due to the progressive electro-anatomical changes that occur with AF persistence and the spread of arrhythmogenic triggers and substrates outside of the pulmonary veins. The posterior wall of the left atrium is a common site for these changes and has become a target of ablation strategies to treat these more resistant forms of AF. In this review, we discuss the role of the posterior left atrial wall in persistent and long-standing persistent AF, the limitations of current endocardial-focused treatment strategies, and future perspectives on hybrid epicardial–endocardial approaches to posterior wall isolation or ablation.

scholarly journals P905One year follow-up of box isolation in persistent atrial fibrillation ablation: role of insertable cardiac monitoring

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii177-iii178
Author(s):  
G. Sirico ◽  
M. Morosato ◽  
S. Panigada ◽  
L. Ottaviano ◽  
V. De Sanctis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Persistent Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
Cardiac Monitoring

scholarly journals Imaging of pulmonary veins during catheter ablation for atrial fibrillation: the role of multi-slice computed tomography

EP Europace ◽  
2008 ◽  
Vol 10 (Supplement 3) ◽  
pp. iii14-iii21 ◽  
Author(s):  
H. Niinuma ◽  
R. T. George ◽  
A. Arbab-Zadeh ◽  
J. A.C. Lima ◽  
C. A. Henrikson
Keyword(s):  
Computed Tomography ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Pulmonary Veins

scholarly journals Is Catheter Ablation Better Than Antiarrhythmic Drugs for the Treatment of Atrial Fibrillation?

2020 ◽  
Vol 29 (02) ◽  
pp. 131-140
Author(s):  
Balaji Natarajan ◽  
Srishti Nayak ◽  
Ramdas G. Pai
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Persistent Atrial Fibrillation ◽  
Poor Quality ◽  
Treatment Side Effects ◽  
Randomized Controlled Studies ◽  
Antiarrhythmic Medications ◽  
Better Than

AbstractLong-standing atrial fibrillation is associated with significant morbidity including stroke and development of heart failure. Patients also report poor quality of life as a result of debilitating symptoms or treatment side effects from antiarrhythmic medications. Radio frequency or cryothermal mediated catheter ablation has a central role in the management of symptomatic patients with paroxysmal or persistent atrial fibrillation. Circumferential pulmonary vein isolation is vital to the success of this therapy and other ancillary techniques have been described, especially for persistent atrial fibrillation. Several randomized controlled studies have been reported over the last two decades studying important clinical outcomes in patients with atrial fibrillation. In this article, we aim to provide a review of the major studies that have helped define the role of catheter ablation in the management of symptomatic atrial fibrillation in patients with both diseased and structurally normal hearts.

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