14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-139

A novel microcatheter approach to the ablation of atrial fibrillation: safety and feasibility in 43 patients

Michelle Adam, Zoltan Csanadi, Claudio Tondo, Paolo Della Bella, Roberto De Ponti, Jorge A. Salerno, George Theodorakis, Ernst G. Vester, Annibale Sandro Montenero, for the REVELATION™.
European Atrial Fibrillation Group

Introduction

Atrial fibrillation is a common disorder affecting 0.5% of individuals 50 to 55 years and up to 8% of those over 70 years. Atrial fibrillation is usually related to rheumatic and coronary heart disease, heart failure, mitral valve prolapse, hypertension, cardiomyopathies and endocrine diseases but occurs in the absence of any other detectable cardiac abnormality in about 10% of the cases. The electrophysiological mechanisms that initiate and maintain atrial fibrillation may be multiple and cause different patterns of atrial fibrillation^1,2. Electrophysiological mapping performed during atrial fibrillation indicates that different patterns of atrial activation in the same patient are related to the existence of different migratory reentrant wavelets in both atria^3,4, and Gaita et al⁵ have recently explored the relationship that may exist between these patterns of activation and the success of atrial fibrillation ablation. This was the rationale for surgical atriotomy procedures⁶ and, more recently, catheter-mediated ablation lines⁷ as an emerging therapeutical approach for medically refractory paroxysmal AF. Radiofrequency (RF) catheter mediated ablation lines were initially performed with an anatomical approach, mimicking the Maze operation⁷, and recently Gaita⁵ described the effects of this type of catheter ablation on right atrial activation in patients with the so-called “vagal form” of idiopathic AF. Therefore, the European Study Group for Atrial Fibrillation planned a prospective study to evaluate the effects of linear ablation in the right atrium in patients with drug refractory “lone” paroxysmal atrial fibrillation.

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