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Yu-Feng Hu,
Tsui-Lieh Hsu,
Wen-Chung Yu,
Sung-Hao Huang,
Hsuan-Ming Tsao,
Ching-Tai Tai,
Yenn-Jiang Lin, Shih-Lin Chang,
Li-Wei Lo,
Ta-Chuan Tuan,
Chien-Jung Chang,
Wen-Chin Tsai,
Pi-Chang Lee,
Wei-Hua Tang,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: The presence of diastolic dysfunction increases the risk of atrial fibrillation (AF), and might be associated with the left atrial (LA) substrate. The aim of the present study was to investigate the relationships between the diastolic dysfunction, atrial substrate and outcome of the catheter ablation.
Eighty-three patients with paroxysmal AF were enrolled. Diastolic dysfunction was defined as a left ventricular ejection fraction (LVEF) of ≥ 50%, and one of the following criteria: (1) a mitral inflow early filling velocity to atrial filling velocity ratio (E/A) of ≤ 0.75; or (2) an E/A ratio of >0.75 and a ratio of the mitral inflow early filling velocity to the velocity of the early medial mitral annular ascent of >10. Patients with diastolic dysfunction were older than those with normal cardiac function. There were no differences in the other baseline characteristics, LA diameter, or LVEF. A decreased LA voltage, and higher recurrence rate were noted in patients with diastolic dysfunction. In the univariate analysis, the patients with recurrence had a lower LA voltage and greater diastolic dysfunction. The multivariate analysis also indicated diastolic dysfunction and LA voltage as independent predictors of recurrence.
The patients with diastolic dysfunction developed a different atrial substrate and had a worse outcome of catheter ablation for atrial fibrillation.
Circulation Journal 10/2010; 74(10):2074-8. · 3.77 Impact Factor
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Cheng-Hung Li,
Yu-Feng Hu,
Yenn-Jiang Lin, Shih-Lin Chang,
Li-Wei Lo,
Tuan Ta-Chuan,
Pi-Chang Lee,
Shih-Yu Huang,
Kazuyoshi Suenari,
Nguyen Huu Tung,
Ching-Tai Tai,
Tze-Fan Chao,
Chern-En Chiang,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: Information about the impact of age on the electrophysiological characteristics of accessory pathways (APs) in patients with Wolff-Parkinson-White (WPW) syndrome remains limited.
A total of 1,885 consecutive patients (mean age 43 ± 17 years, male 61.5%) with WPW syndrome who were referred to the tertiary center for an electrophysiological study and radiofrequency catheter ablation were investigated. The patients were divided into 4 groups based on their age (Group 1: <20; Group 2: 20-39; Group 3: 40-59; Group 4: ≧60 years old). With age, more left-sided APs (53.2%, 67.7%, 71.7%, 75.7%, P < 0.001) and a longer duration of the arrhythmia (4.3 ± 2.8 years, 10.1 ± 7.0 years, 12.4 ± 10.9 years, 14.0 ± 12.4 years, P < 0.001) were noted. The incidence of concealed APs (53.5%, 53.0%, 57.8%, 60.9%, P = 0.01), and orthodromic atrioventricular (AV) reentrant tachycardia (92.4%, 94.2%, 96.5%, 96.3%, P = 0.023) increased with age. The tachycardia cycle length, antegrade (275.5 ± 42.2 ms, 286.7 ± 62.7 ms, 302.5 ± 66.5 ms, 315.2 ± 80.2 ms, P < 0.001) and retrograde AP effective refractory periods (APERPs) (254.0 ± 42.5 ms, 263.3 ± 51.8 ms, 274.5 ± 100.5 ms, 292.7 ± 57.0 ms, P < 0.001), atrial ERP, antegrade AV node effective refractory period (AVNERP), and ventricular effective refractory period (VERP) lengthened as the age increased. The incidence of decremental APs, multiple APs, and a catecholamine response were similar. The duration of the catheter ablation, total fluoroscopy time, acute success rate, complication rate, and incidence of a secondary procedure were similar between the different age groups.
The electrophysiological characteristics and pattern of the arrhythmic attack associated with the AP changed with age.
Journal of Cardiovascular Electrophysiology 10/2010; 22(3):274-9. · 3.06 Impact Factor
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Li-Wei Lo,
Hsuan-Ming Tsao,
Yenn-Jiang Lin, Shih-Lin Chang,
Yu-Feng Hu,
Wen-Chin Tsai,
Ta-Chun Tuan,
Kazuyoshi Suenari,
Shih-Yu Huang,
Nguyen-Huu Tung,
Satoshi Higa,
Ching-Tai Tai,
Kwo-Chang Ueng,
Cheng-Hung Li,
Tze-Fan Chao,
Tsu-Juey Wu,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: Multiple remodeling patterns have been observed after catheter ablation of atrial fibrillation (AF).
We aimed to clarify the electrical/structural properties associated with recurrences after ablation of chronic AF.
After a stepwise ablation procedure in 120 consecutive patients with persistent/long-lasting persistent AF, 36 had a recurrence of AF (Group 1/Group 2: recurrence with paroxysmal/persistent AF, n = 16/20).
During the first procedure, the left atrial (LA) bipolar voltage did not differ between the 2 groups, and the LA volume was smaller in Group 1 than in Group 2 and it was the only factor predicting the recurrent types (P = 0.009, OR = 1.04). In the second procedure, the bipolar voltage of the global left atrium increased (1.33 ± 0.11 mV vs 1.76 ± 0.16 mV, P = 0.001) in Group 1 and decreased (1.31 ± 0.14 mV vs 0.90 ± 0.12 mV, P = 0.01) in Group 2, when compared with that of the first procedure. The LA low-voltage area (<0.5 mV) decreased in Group 1, and increased in Group 2. The LA volume (90 ± 8 cm(3) vs 72 ± 8 cm(3), P = 0.002) decreased in the second procedure in Group 1. It remained the same in Group 2. The right atrial substrates did not change between the procedures. After a follow-up of 27 ± 3 months, all patients in Group 1 and 14 patients in Group 2 remained in sinus rhythm (P = 0.02).
A better outcome with reverse electrical and structural remodeling occurred after the ablation of chronic AF when the recurrence was paroxysmal AF. Progressive electrical remodeling without any structural remodeling developed in those with a recurrence involving persistent AF.
Journal of Cardiovascular Electrophysiology 10/2010; 22(4):385-93. · 3.06 Impact Factor
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Yenn-Jiang Lin,
Hsuan-Ming Tsao, Shih-Lin Chang,
Li-Wei Lo,
Yu-Feng Hu,
Chien-Jung Chang,
Wen-Chin Tsai,
Kazuyoshi Suenari,
Shih-Yu Huang,
Hsing-Ya Chang,
Tsu-Juey Wu,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: The adjunctive role of dominant frequency (DF) mapping during complex fractionated electrogram (CFE) ablation of atrial fibrillation (AF) has not been clarified.
The purpose of this study was to investigate whether DF distribution or substrate properties are related to fibrillatory activity in the left atrium (LA) and to evaluate the effect of CFE ablation on the different patterns of DF distribution.
The study enrolled 50 nonparoxysmal AF patients who underwent mapping, pulmonary vein isolation, and CFE ablation. High-density DF and CFE mapping were performed from the center of DF(max) centrifugally to the rest of the LA. The LA substrate was classified into two types depending on the presence of intra-LA DF gradients as type 1 (>20% of the average DF) or type 2 (<20% of the average DF).
In type 1, maximal CFE and DF gradients were observed at the boundary (n = 14) or center (n = 16) of the DF(max) region. In type 2 (n = 20), less intra-LA DF gradient was observed (4.27 +/- 1.92 Hz vs 1.14 +/- 0.52 Hz for types 1 and 2, P <.001) and a large proportion of continuous CFEs extended from the center of DF(max) (19% +/- 11% and 42% +/- 15% of the LA for types 1 and type 2, P = .001). The procedure termination rate and long-term sinus rhythm maintenance rate were lower in patients with a smaller DF gradient (P <.05).
The spatial distribution of fractionated activity was associated with particular DF patterns in nonparoxysmal AF patients. Patients with an evident intra-LA DF gradient responded better to pulmonary vein isolation and continuous CFE ablation.
Heart rhythm: the official journal of the Heart Rhythm Society 09/2010; 7(9):1255-62. · 4.56 Impact Factor
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Li-Wei Lo,
Satoshi Higa,
Yenn-Jiang Lin, Shih-Lin Chang,
Ta-Chuan Tuan,
Yu-Feng Hu,
Wen-Chin Tsai,
Hsuan-Ming Tsao,
Ching-Tai Tai,
Sugako Ishigaki,
Asuka Oyakawa,
Minetaka Maeda,
Kazuyoshi Suenari,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: The noncontact mapping (NCM) system possesses the merit of global endocardial recording for unipolar and activation mapping. Objective: We aimed to evaluate the unipolar electrogram characteristics and activation pattern over the bipolar complex fractionated atrial electrogram (CFAE) sites during atrial fibrillation (AF).
Twenty patients (age 55 +/- 11 years old, 15 males) who underwent NCM and ablation of AF (paroxysmal/persistent = 13/7) were included. Both contact bipolar (32-300 Hz) and NCM virtual unipolar electrograms (0.5-300 Hz) were simultaneously recorded along with the activation pattern (total 223 sites, 11 +/- 4 sites/patient). A CFAE was defined as a mean bipolar cycle length of <or= 120 ms with an intervening isoelectric interval of more than 50 ms (Group 1A, n = 63, rapid repetitive CFAEs) or continuous fractionated activity (Group 1B, n = 59, continuous fractionated CFAEs), measured over a 7.2-second duration. Group 2 consisted of those with a bipolar cycle length of more than 120 ms (n = 101).
The Group 1A CFAE sites exhibited a shorter unipolar electrogram cycle length (129 +/- 11 vs 164 +/- 20 ms, P < 0.001), and higher percentage of an S-wave predominant pattern (QS or rS wave, 63 +/- 13% vs 35 +/- 13%, P < 0.001) than the Group 2 non-CFAE sites. There was a linear correlation between the bipolar and unipolar cycle lengths (P < 0.001, R = 0.87). Most of the Group 1A CFAEs were located over arrhythmogenic pulmonary vein ostia or nonpulmonary vein ectopy with repetitive activations from those ectopies (62%) or the pivot points of the turning wavefronts (21%), whereas the Group 1B CFAEs exhibited a passive activation (44%) or slow conduction (31%).
The bipolar repetitive and continuous fractionated CFAEs represented different activation patterns. The former was associated with an S wave predominant unipolar morphology which may represent an important focus for maintaining AF.
Journal of Cardiovascular Electrophysiology 06/2010; 21(6):640-8. · 3.06 Impact Factor
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Kazuyoshi Suenari,
Yu-Feng Hu,
Hsuan-Ming Tsao,
Ching-Tai Tai,
Chern-En Chiang,
Yenn-Jiang Lin, Shih-Lin Chang,
Li-Wei Lo,
Tuan Ta-Chuan,
Pi-Chang Lee,
Nguyen Huu Tung,
Shih-Yu Huang,
Tsu-Juey Wu,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: The detailed electrophysiological characteristics of the gender differences associated with atrioventricular nodal reentrant tachycardia (AVNRT) have not been clarified. This study investigated the gender-related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation.
A total of 2,088 consecutive AVNRT patients (men/women 869/1,219) who underwent catheter ablation were enrolled in this study. We evaluated the gender differences in their electrophysiological characteristics. Women had a significantly younger age of onset, higher incidence of multiple jumps, shorter AH interval, atrial effective refractory period (ERP), anterograde fast pathway ERP, anterograde slow pathway ERP, and retrograde slow pathway ERP, and longer ventricular ERP than men. The incidence of baseline ventriculoatrial dissociation was lower in women than in men. Women needed less isoproterenol/atropine to induce AVNRT. No gender differences in the radiation exposure time, procedure time, complication rate, acute success rate, or second procedure rate were noted. Both typical and atypical AVNRT were more predominant in women. In the patients with atypical AVNRT, there was no significant gender difference in incidence of baseline ventriculoatrial dissociation; however, the retrograde slow pathway ERP was significantly shorter in women than in men. Women of premenopausal age (≤50 years old) had a significantly higher incidence of anterograde multiple jumps and a retrograde jump phenomenon, and a shorter anterograde slow pathway ERP and retrograde slow pathway ERP than those of women over 50 years old.
Gender differences in the anterograde and retrograde AV nodal electrophysiology were noted in the patients with AVNRT.
Journal of Cardiovascular Electrophysiology 04/2010; 21(10):1114-9. · 3.06 Impact Factor
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Ta-Chuan Tuan, Shih-Lin Chang,
Hsuan-Ming Tsao,
Ching-Tai Tai,
Yenn-Jiang Lin,
Yu-Feng Hu,
Li-Wei Lo,
Ameya R Udyavar,
Chien-Jong Chang,
Wen-Chin Tsai,
Wei-Hua Tang,
Kazuyoshi Suenari,
Shih-Yu Huang,
Pi-Change Lee,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: Previous studies have indicated that atrial fibrillation (AF) in patients over the age of 60 at diagnosis is a risk factor for a substantial increase in cardiovascular events. However, information about the impact of age on the atrial substrate and clinical outcome after catheter ablation of AF is limited.
This study included 350 patients (53 ± 12 years, 254 males) who underwent circumferential pulmonary vein isolation (CPVI) of AF, guided by a NavX mapping system. The subjects were divided into three groups according to their age, as follows: Group I: age ≤50 (n = 141), Group II: age = 51-64 (n = 149) and Group III: age ≥65 years old (n = 60). The mean voltage and total activation time of the individual atria were obtained by using a NavX mapping system before ablation. Several parameters, including the gender, AF duration, and left atrial (LA) diameter were analyzed.
The younger age group had a significantly smaller LA diameter (Group I vs Group II vs Group III, 36.89 ± 7.11 vs 39.16 ± 5.65 vs 40.77 ± 4.95 mm, P = 0.002) and higher LA bipolar voltage (2.09 ± 0.83 vs 1.73 ± 0.73 vs 1.86 ± 0.67 mV, respectively, P = 0.024), compared with the older AF patients. The LA bipolar voltage exhibited a significant reduction when the patients became older, however, that did not occur in the right atrium. The incidence of an AF recurrence was higher in the older age group than in the younger age groups. A subgroup of patients with lone AF was analyzed and age was found to be an independent predictor of the AF recurrence after receiving the first CPVI in the multivariable model (P < 0.05).
Age has a significant impact on the LA substrate properties and outcome of the catheter ablation of AF.
Journal of Cardiovascular Electrophysiology 04/2010; 21(9):966-72. · 3.06 Impact Factor
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Journal of Cardiovascular Electrophysiology 03/2010; 21(8):940-1. · 3.06 Impact Factor
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[show abstract]
[hide abstract]
ABSTRACT: We report a case of focal atrial tachycardia (AT) originating from prior superior vena cava isolation line. The P-wave morphology in lead aVL during the AT differed from that during sinus rhythm although their foci were in close proximity to each other. We discuss the mechanism based on the activation maps of the right atrium.
Pacing and Clinical Electrophysiology 03/2010; 33(10):e100-1. · 1.35 Impact Factor
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Heart rhythm: the official journal of the Heart Rhythm Society 02/2010; 8(3):484-5. · 4.56 Impact Factor
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Yenn-Jiang Lin,
Hsuan-Ming Tsao, Shih-Lin Chang,
Li-Wei Lo,
Ta-Chuan Tuan,
Yu-Feng Hu,
Ameya R Udyavar,
Wen-Chin Tsai,
Chien-Jung Chang,
Ching-Tai Tai,
Pi-Chang Lee,
Kazuyoshi Suenari,
Shih-Yu Huang,
Huu Tung Nguyen,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: Previous studies have reported that increased high-sensitive C-reactive protein (hs-CRP) levels are associated with an inflammatory state. This study investigated the association among hs-CRP, substrate properties, and long-term clinical outcomes after catheter ablation of atrial fibrillation (AF). A total of 137 patients with AF (54 +/- 13 years) who underwent mapping and catheter ablation were included. The hs-CRP was measured before the first ablation procedure. The substrate properties (initiating triggers, biatrial mean voltage, and high-frequency sites) of the 2 atria and long-term outcome were investigated in patients in the low hs-CRP group (<75%, 2.92 mg/L) and high hs-CRP group (>75%, 2.92 mg/L). Patients with a higher hs-CRP were associated with an increased number of identified nonpulmonary vein ectopies (34.4% vs 17%, p = 0.034), lower mean left atrial (LA) voltage (1.72 +/- 0.73 vs 1.92 +/- 0.72 Hz, p = 0.045), and higher-frequency sites in the left atrium (71% vs 37%, p = 0.027). After a median follow-up period of 15 months, the single-procedure success rate (72% vs 53%, p = 0.008) and final success rate after multiple procedures (94% vs 81%, p = 0.02) were higher in the low hs-CRP group. In a multivariable regression model adjusted for other potential covariates, hs-CRP level (p = 0.021) and LA diameter (p = 0.032) were independent predictors of recurrence. In conclusion, baseline CRP levels before the first AF ablation procedure had an independent prognostic value in predicting long-term recurrence. Patients with a high hs-CRP level were associated with an abnormal LA substrate and high incidence of nonpulmonary vein AF sources.
The American journal of cardiology 02/2010; 105(4):495-501. · 3.58 Impact Factor
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Heart rhythm: the official journal of the Heart Rhythm Society 01/2010; 7(5):673-4. · 4.56 Impact Factor
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[show abstract]
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ABSTRACT: The right atrial appendage atrial tachycardia (RAA AT) has been previously reported as a rare site in focal AT. We report a patient with a history of a right pneumonectomy who underwent catheter ablation of the AT originating from the RAA. This RAA AT showed unusual P-wave morphology compared with previous reports. We describe the RAA AT following right pneumonectomy using a NavX system (St. Jude Medical, St. Paul, MN, USA).
Pacing and Clinical Electrophysiology 12/2009; 33(5):e46-8. · 1.35 Impact Factor
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[show abstract]
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ABSTRACT: A 29-year-old female with a documented ventricular tachycardia exhibiting two different electrocardiogram (ECG) morphologies in the precordial leads was referred for catheter ablation. We describe the mechanism of the dual ECG morphologies in this case.
Europace 12/2009; 12(4):592-4. · 1.98 Impact Factor
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Chien-Jung Chang,
Yenn-Jiang Lin,
Satoshi Higa, Shih-Lin Chang,
Li-Wei Lo,
Ta-Chuan Tuan,
Yu-Feng Hu,
Ameya R Udyavar,
Wei-Hua Tang,
Wen-Chin Tsai,
Shin-Yu Huang,
Nguyen-Huu Tung,
Kazuyoshi Suenari,
Hsuan-Ming Tsao,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: The peak electrogram voltage is a typical metric applied at each site for voltage mapping. However, the peak amplitude depends on the direction and complexity of the wavefront propagation. The root-mean-square (RMS) measure of the amplitude is a temporal integral that represents the steady-state value. The objective of this study was to investigate the disparities between the electrogram voltage during SR and AF by using 2 recording modalities: the conventional peak voltage and an RMS measurement.
This study enrolled 20 patients (age = 59 +/- 13) with paroxysmal AF undergoing catheter ablation guided by Ensite array. The unipolar electrogram voltage during SR and AF (7 seconds in duration) was obtained from the same sites, and labeled by the 3-dimensional (3D) geometry. Overall 1,200 electrograms were analyzed from equally distributed mapping sites in the left atrium. A point-by-point comparison of the unipolar peak negative voltage (PNV) showed less agreement (Bland and Altman test: 10.4% outside 2 standard deviations, and intraclass correlation coefficient [ICC]= 0.64). The RMS voltage demonstrated agreement between SR and AF for all sites (BA test: 5.9% of the sites, and the ICC = 0.81). The probability of predicting a low-voltage during AF using the voltage during SR was significantly lower when using the PNV measurement compared to that when using the RMS voltage (15% vs 61%, P < 0.05).
The peak electrogram unipolar voltage during AF did not represent the voltage during SR. The RMS amplitude may be an alternative metric for voltage mapping to characterize the myocardial substrate.
Journal of Cardiovascular Electrophysiology 11/2009; 21(4):393-8. · 3.06 Impact Factor
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Hsuan-Ming Tsao,
Wei-Chih Hu,
Mei-Han Wu,
Ching-Tai Tai, Shih-Lin Chang,
Yenn-Jiang Lin,
Li-Wei Lo,
Chin-Chou Huang,
Yu-Feng Hu,
Ming-Huei Sheu,
Cheng-Yen Chang,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: Elucidating the functional properties and remodeling process of the entire left atrium (LA) is important not only for offering the mechanistic insight into atrial fibrillation (AF) but also for assessing the effectiveness of catheter ablation.
We included 65 patients with paroxysmal AF and 29 controls. Baseline multidetector computed tomography (MDCT) was acquired in all subjects and a follow-up MDCT was available in 48 patients after pulmonary vein and LA ablation. The 3-dimensional images at atrial end-diastole (ED) and end-systole (ES) were analyzed.
The LA volume (ED: 61.11 +/- 15.94 vs 54.12 +/- 8.94 mL/m(2), P = 0.03; ES: 45.29 +/- 17.64 vs 33.38 +/- 7.78 mL/m(2), P < 0.001) was increased, and ejection fraction (EF) (26.93 +/- 13.40 vs 38.09 +/- 11.62%, P < 0.001) decreased in AF patients as compared to controls. After ablation, the ES LA volume (44.73 +/- 14.93 vs 38.04 +/- 11.51 mL/m(2), P = 0.04) decreased and the LA EF (25.04 +/- 13.13 vs 30.82 +/- 7.85%, P = 0.03) increased in patients without any AF recurrence. The wall motion (WM) analysis of the 18 segments of LA revealed increased motional magnitudes of entire LA except for the anterior roof. In contrast, the volume, EF, and WM of LA remained similar in patients with recurrence.
Dilated LA with global hypokinesia was noted in AF patients. Improved LA transport function was demonstrated in patients without any recurrence after ablation. However, the anatomic and functional reverse remodeling was not significant in patients with AF recurrence.
Journal of Cardiovascular Electrophysiology 10/2009; 21(3):270-7. · 3.06 Impact Factor
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Li-Wei Lo,
Yenn-Jiang Lin,
Hsuan-Ming Tsao, Shih-Lin Chang,
Yu-Feng Hu,
Wen-Chin Tsai,
Da-Chun Tuan,
Chien-Jung Chang,
Pi-Chang Lee,
Ching-Tai Tai,
Wei-Hua Tang,
Kazuyoshi Suenari,
Shih-Yu Huang,
Satoshi Higa,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: Nonpulmonary vein (PV) ectopy initiating atrial fibrillation (AF)/atrial tachycardia (AT) is not uncommon in patients with AF. The relationship of complex fractionated atrial electrograms (CFAEs) and non-PV ectopy initiating AF/AT has not been assessed. We aimed to characterize the CFAEs in the non-PV ectopy initiating AF/AT.
Twenty-three patients (age 53 +/- 11 y/o, 19 males) who underwent a stepwise AF ablation with coexisting PV and non-PV ectopy initiating AF or AT were included. CFAE mapping was applied before and after the PV isolation in both atria by using a real-time NavX electroanatomic mapping system. A CFAE was defined as a fractionation interval (FI) of less than 120 ms over 8-second duration. A continuous CFAE (mostly, an FI < 50 ms) was defined as electrogram fractionation or repetitive rapid activity lasting for more than 8 seconds.
All patients (100%) with non-PV ectopy initiating AF or AT demonstrated corresponding continuous CFAEs at the firing foci. There was no significant difference in the FI among the PV ostial or non-PV atrial ectopy or other atrial CFAEs (54.1 +/- 5.6, 58.3 +/- 11.3, 52.8 +/- 5.8 ms, P = 0.12). Ablation targeting those continuous CFAEs terminated the AF and AT and eliminated the non-PV ectopy in all patients (100%). During a follow-up of 7 months, 22% of the patients had an AF recurrence with PV reconnections. There was no recurrence of any ablated non-PV ectopy during the follow-up.
The sites of the origin of the non-PV ectopies were at the same location as those of the atrial continuous CFAEs. Those non-PV foci were able to initiate and sustain AF/AT. By limited ablation targeting all atrial continuous CFAEs, the AF could be effectively eliminated.
Journal of Cardiovascular Electrophysiology 10/2009; 20(12):1305-12. · 3.06 Impact Factor
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Journal of Cardiovascular Electrophysiology 09/2009; 20(12):1408-9. · 3.06 Impact Factor
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Journal of Cardiovascular Electrophysiology 09/2009; 21(1):105-6. · 3.06 Impact Factor
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Yu-Feng Hu,
Jin-Long Huang,
Tsu-Juey Wu,
Satoshi Higa,
Chun-Ming Shih,
Ching-Tai Tai,
Yenn-Jiang Lin, Shih-Lin Chang,
Li-Wei Lo,
Tuan Ta-Chuan,
Chien-Jong Chang,
Wen-Chin Tsai,
Pi-Chang Lee,
Hsuan-Ming Tsao,
Sugako Ishigaki,
Asuka Oyakawa,
Shih-Ann Chen
[show abstract]
[hide abstract]
ABSTRACT: Gender differences of supraventricular tachycardias such as atrioventricular nodal re-entry, atrioventricular re-entry, and atrial fibrillation have been reported. There is little evidence of the effect of gender on focal atrial tachycardia (FAT). The study consisted of 298 patients who were referred to this institution for radiofrequency catheter ablation of FAT from October 1992 to April 2008 and included 156 men (52%) and 142 women (48%). Men were significantly older than women (57.9 +/- 18.2 vs 47.2 +/- 19.0 years old, p <0.001). Women had more associated arrhythmias (17.0% vs 28.9%, p = 0.01), mostly due to an increased incidence of atrioventricular nodal re-entrant tachycardia. Men had more cardiovascular co-morbidities (19.9% vs 9.9%, p = 0.02), a mechanism of increased automaticity (19.1% vs 8.1%, p = 0.01), and nonparoxysmal tachycardia (14.7% vs 4.4%, p = 0.01). No gender differences were noted among FAT number, left atrial involvement, shortest tachycardia cycle, success rate of catheter ablation, or recurrence rate of FAT. Mean duration of follow-up was 63.2 +/- 47.5 months. Premenopausal women had a lesser cardiovascular co-morbidity (15.3% vs 4.3%, p = 0.04) and a greater incidence of a mechanism of increased automaticity (13.4% vs 2.9%, p = 0.03). In conclusion, gender differences in electrophysiologic characteristics were noted in FAT.
The American journal of cardiology 08/2009; 104(1):97-100. · 3.58 Impact Factor
