Trigger activity more than three years after left atrial linear ablation without pulmonary vein isolation in patients with atrial fibrillation.

Tanner, Hildegard; Hindricks, Gerhard; Kobza, Richard; Dorszewski, Anja; Schirdewahn, Petra; Piorkowski, Christopher; Gerds-Li, Jin-Hong; Kottkamp, Hans (2005). Trigger activity more than three years after left atrial linear ablation without pulmonary vein isolation in patients with atrial fibrillation. Journal of the American College of Cardiology, 46(2), pp. 338-343. Elsevier 10.1016/j.jacc.2005.03.063

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OBJECTIVES

The aim of this study was to analyze trigger activity in the long-term follow-up after left atrial (LA) linear ablation.

BACKGROUND

Interventional strategies for curative treatment of atrial fibrillation (AF) are targeted at the triggers and/or the maintaining substrate. After substrate modification using nonisolating linear lesions, the activity of triggers is unknown.

METHODS

With the LA linear lesion concept, 129 patients were treated using intraoperative ablation with minimal invasive surgical techniques. Contiguous radiofrequency energy-induced lesion lines involving the mitral annulus and the orifices of the pulmonary veins without isolation were placed under direct vision.

RESULTS

After a mean follow-up of 3.6 +/- 0.4 years, atrial ectopy, atrial runs, and reoccurrence of AF episodes were analyzed by digital 7-day electrocardiograms in 30 patients. Atrial ectopy was present in all patients. Atrial runs were present in 25 of 30 patients (83%), with a median number of 9 runs per patient/week (range 1 to 321) and a median duration of 1.2 s/run (range 0.7 to 25), without a significant difference in atrial ectopy and atrial runs between patients with former paroxysmal (n = 17) or persistent AF (n = 13). Overall, 87% of all patients were completely free from AF without antiarrhythmic drugs.

CONCLUSIONS

A detailed rhythm analysis late after specific LA linear lesion ablation shows that trigger activity remains relatively frequent but short and does not induce AF episodes in most patients. The long-term success rate of this concept is high in patients with paroxysmal or persistent AF.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Tanner, Hildegard
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0735-1097
Publisher:	Elsevier
Language:	English
Submitter:	Hildegard Tanner
Date Deposited:	16 Jul 2014 17:08
Last Modified:	05 Dec 2022 14:28
Publisher DOI:	10.1016/j.jacc.2005.03.063
PubMed ID:	16022965
URI:	https://boris.unibe.ch/id/eprint/42309