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Significant reduction of atrial defibrillation threshold and inducibility by catheter ablation of atrial fibrillation.

Title
 Significant reduction of atrial defibrillation threshold and inducibility by catheter ablation of atrial fibrillation. 
Authors
 EUI-SEOCK HWANG ; GI BYUNG NAM ; HUI-NAM PAK ; MOON HYOUNG LEE ; JAE-SUN UHM ; JAEMIN SHIM ; JIHEI SARA LEE ; JUNBEOM PARK ; BOYOUNG JOUNG 
Issue Date
2012
Journal Title
 PACE-Pacing and Clinical ElectroPhysiology 
ISSN
 0147-8389 
Citation
 PACE-Pacing and Clinical ElectroPhysiology, Vol.35(12) : 1428~1435, 2012 
Abstract
Background: Radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has antiarrhythmic effects by multiple mechanisms. We hypothesized that RFCA curtails atrial defibrillation threshold (A-DFT) and postablation induction pacing cycle length (iPCL), making critical mass reduction one potential mechanism by which antiarrhythmic effect is achieved. Methods: We included 289 patients with AF (male 77.9%, 55.7 ± 10.8 years old; 197 paroxysmal AF: 92 persistent AF) who underwent RFCA. A-DFT (serial internal cardioversion 2, 3, 5, 7, and 10 J) and iPCL (serial 10 mA 10-second atrial pacing with pacing cycle length 250, 200, 190, 180, 170, 160, and 150 ms) were evaluated before and after RFCA. Results: (1) RFCA of AF reduced the A-DFT from 6.7 ± 3.7 J to 3.0 ± 3.0 J (P < 0.001). (2) AF ablation reduced AF inducibility from 95.4% before the procedure to 56.3% after the procedure (P < 0.001), and the iPCL from 194.8 ± 32.6 to 160.9 ± 26.2 ms (P < 0.001). (3) In patients who underwent a greater number of ablation lines, the post-RFCA A-DFT (P < 0.001) was lower, and %ΔA-DFT (P = 0.003) and proportion of atrial tachycardia (P = 0.022) were higher than those with a lower number of ablation lines. Conclusion: AF ablation significantly reduced A-DFT, AF inducibility, and iPCL, and the degree of their reduction was related to the number of ablation lines.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/91627
DOI
10.1111/j.1540-8159.2012.03517.x
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8159.2012.03517.x/abstract
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