OBJECTIVES This study evaluated the role of pre-procedural clinical variables to predict procedural and clinical outcomes of catheter ablation in patients with long-lasting persistent atrial fibrillation (AF). BACKGROUND Catheter ablation of persistent AF remains a challenging task. METHODS Catheter ablation was performed in 90 patients (76 men, age 57 +/- 11 years) with long-lasting persis...

Introduction Catheter ablation is an effective therapeutic strategy for atrial fibrillation (AF). Pulmonary vein (PV) isolation is the cornerstone of catheter ablation for AF. After all PVs were isolated, ablation of non-PV triggers should be attempted. Successful elimination of all the possible AF triggers is considered a better outcome. Mapping of non-PV triggers is usually performed using 3-...

We describe a simple and safe technique to position a bipolar radio-frequency ablation device around the pulmonary veins when performing pulmonary vein isolation. The technique consists of insertion of a rubber catheter with stylet, originally an introducer from a left vent catheter, behind the pulmonary veins, and subsequent placement of the lower jaw of the ablation clamp using a rubber cathe...

OBJECTIVES The purpose of this study was to categorize the reasons for a prolonged or failed procedure in a series of patients undergoing catheter ablation of an accessory pathway. BACKGROUND Radiofrequency ablation of accessory pathways at times requires a lengthy procedure or a second ablation session, or both, and not prior studies have systematically investigated the reasons for this. M...

OBJECTIVE To review the effectiveness, safety, and costing of ablation methods to manage atrial fibrillation (AF). The ablation methods reviewed were catheter ablation and surgical ablation. CLINICAL NEED Atrial fibrillation is characterized by an irregular, usually rapid, heart rate that limits the ability of the atria to pump blood effectively to the ventricles. Atrial fibrillation can be a...

Background The purpose of this study was to evaluate electrode temperatures obtained using a radiofrequency ablation system that incorporates closed loop feedback control to achieve preset target electrode temperatures and to determine if closed loop temperature control results in a lower incidence of developing a coagulum. Methods and Results Two hundred seventy patients underwent catheter abl...

BACKGROUND Catheter ablation of atrial fibrillation is currently guided by x-ray fluoroscopy. The associated radiation risk to patients and medical staff may be significant. We report an atrial fibrillation ablation technique using intracardiac echocardiography (ICE) and electroanatomic mapping without fluoroscopy. METHODS AND RESULTS Twenty-one patients with atrial fibrillation (age, 42 to 7...

AIMS Recurrent arrhythmias after ablation procedures are often caused by recovery of ablated tissue. Robotic catheter manipulation systems increase catheter tip stability which improves energy delivery and could produce more transmural lesions. We tested this assertion using bipolar voltage attenuation as a marker of lesion quality comparing robotic and manual circumferential pulmonary vein abl...

A single suction electrode catheter was used for His bundle electrogram recording. His bundle pacing, and low-energy (20 or 30 J) His bundle ablation in seven dogs. The suction electrode catheter was actively fixed to the atrial endocardium at the His bundle level. Electrophysiologic studies were performed in the control state, immediately after, and late (greater than 40 days) after His bundle...

BACKGROUND Atrial tachycardia (AT) that develops after ablation of atrial fibrillation often poses a more difficult clinical situation than the index arrhythmia. This study details the use of an impedance-based electroanatomic mapping system (Ensite NavX) in concert with a specialized multielectrode mapping catheter for rapid, high-density atrial mapping. In this study, this activation mapping ...