RT-134
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Is there a relationship between the linear atrial radiofrequency ablation of atrial fibrillation and different parameters of intraatrial conduction time?
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Ildiko J. Dobran, Heike Dees, Christian Perings, Marcus Hennersdorf, Ernst G. Vester.
Department of Cardiology, Pneumology and Angiology, Heinrich-Heine-University, Duesseldorf, Germany
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Abstract
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BACKGROUND. Multilinear atrial radiofrequency ablation (RA) is a
new procedure for the treatment of paroxysmal atrial fibrillation (AF). The aim of our study was 1) to investigate
the relationship between successful RA and changes of the intraatrial signal amplitude after RA 2) to study the
effect of RA on the intraatrial conduction time (A-H time and Pbeginn-Pend/P-wave duration/).
METHODS. Using a new 8 electrode 3,3 Fr microcatheter (REVELATION™ Cardima) radiofrequency energy was
delivered sequentially from two adjacent electrodes as anode and a large back plate as cathode. The following
five lines were drawn in the right atrium. First and second lines: between superior vena cava (SVC) and inferior
vena cava (IVC) (posterior), third line: from SVC to tricuspid valve annulus (TA) (anterior), fourth line: from SVC to
coronary sinus (CS) ostium (posterolateral/septal) and fifth line: IVC and TA (isthmus line). The first four lines
were created using the microcatheter and the ablation of the isthmus was performed using a Cosio™, Medtronic
conventional catheter. In 12 pts (8 female, 4 male, age: 58±12 years) the changes of the A-H time, P wave
morphology and the intra-atrial signal amplitude after RA were measured prospectively.
RESULTS. In 9 pts (75%) with AF/atrial flutter (Aflu) recurrence before RA A-H time were 140±13 vs 152±39 ms after
and the Pbeginn-Pend 99±39 vs 102±21 ms (ns). In 3 pts (25%) with and 9 pts (75 %) without success the reduction
of the signal amplitude (RSA) were 39±19.2 vs 48.6±10% (ns). In 50% of the pts a significant reduction of intraatrial
signal amplitude was achieved after RA. Results values for RSA in means±SD (%). (*p<0.02).
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pts. No.
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line 1
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line 2
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line 3
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line 4
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line 5
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A-H
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Pb-Pc
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Total
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12
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53±14
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41±18
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49±19
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51±19
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42±19
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13±18
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9±7
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no recurr.
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3
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54±3.9
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38±8
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67±1.8
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41±5.7
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43±23
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13±26
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10±5
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A fli.rec.
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6
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41±7
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37±37
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20±0
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75±0
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25±0
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4±3
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5±3
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A flu.rec.
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3
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57±20
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46±17
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47±12
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53±23
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46±19
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28±18
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11±4
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CONCLUSION. The intraatrial conduction time doesn’t show any significant changes in pts with and without
recurrence of AF, however in 50% of the pts after RA there is a significant reduction of intraatrial signal amplitude.
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Key Words
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