Ablation of Atrial Fibrillation by Radiofrequency: Circular Energy Delivery
Pulmonary vein (PV) ablation has entered the therapeutic armamentarium as a curative intervention in a subset of patients with focal atrial fibrillation (AF). Clinical application of this therapy is mainly limited by the potentia risks of pericardial tamponade, thromboembolic events, and PV stenosis. The development of PV stenosis has been documented after these procedures, especially when radiofrequency (RF) delivery is performed within the vein and when circumferential burns with multiple applications are necessary [2, 3]. There is evidence that when energy application are limited to the PV ostium or left atrium to the PV transition area, and when patients do not require a full-circumference PV burn, PV stenosis is observed less frequently than with distalintravenous RF delivery . Therefore, identification of a circumscribed left atrial to PV breakthrough during sinus rhythm or atrial pacing may offer the chance of delivering more ‘focal’ RF, rather than a full-circumference RF application. In addition, RF energy delivery should be limited to the PV ostium, which means methods are verifying the position of the ablation catheter are needed
KeywordsPulmonary Vein Left Atrial Coronary Sinus Catheter Position Radiofrequency Catheter Ablation
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- 6.Burkhardt D, Schimpf R, Bielik H, Schrickel J, Shlevkov N, Yang A, Schwab JO, Lüderitz B, Lewalter T (2002) Decremental pulmonary vein conduction: relevance for ablation in focal atrial fibrillation. Pacing Clin Electrophysiol 25/4:abs 727Google Scholar