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Radiofrequency ablation for atrial fibrillation

P. Jaïs*,1, D.C. Shah2, M. Hocini1, L. Macle1, K.-J. Choi1, M. Haïssaguerre1 and J. Clémenty1

a Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France
b Hôpital Cantonal, University of Geneva, Switzerland

* Docteur Pierre Jaïs, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France

Abstract

Complete cure of atrial fibrillation in highly symptomatic patients can now be achieved using a surgical or catheter based approach. Most electrophysiology laboratories working on catheter ablation for paroxysmal atrial fibrillation target pulmonary veins using a transseptal approach. The aim of the procedure is to achieve complete disconnection of the pulmonary veins, demonstrated by the disappearance or dissociation of their potentials. This is clearly facilitated by the use of a circular catheter dedicated to the mapping of the pulmonary vein ostia, which allows the identification of the connections from the atrium to the vein. Using this approach in targeting all four pulmonary veins, 70% of patients are cured without the need for antiarrhythmic drugs. However, some complications have been described, including tamponade, embolic events and pulmonary vein stenosis. The learning curve for this procedure is steep, but in experienced centres the safety profile is very acceptable.

Key Words: Atria • Atrial fibrillation • Catheter ablation • Pulmonary veins


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