Objective: To investigate the efficacy and safety of circumferential pulmonary vein (PV) linear ablation (CPVA) guided by 3-D mapping system in patients with chronic atrial fibrillation (CAF).
Methods: From August 2004 to November 2005, 100 consecutive patients with CAF were admitted to undergo CPVA guided by CARTO system and EnSite NavX system, the main procedure end point is electrical isolation of PVs. Success was defined as atrial tachyarrhythmia free without any antiarrhythmia drugs for at least 3 months. Clinical and procedural variables were collected, ANOVA analysis was employed to identify the risk factors predicting recurrence, P < 0.05 was considered significant.
Results: After a mean of 9.7 +/- 5.7 months follow up, 70% (70/100) of patients freed from AF. ANOVA analysis identified isthmus ablation and poor left ventricular ejection fraction as the independent factors predicting success. Complications including pericardial tamponade (3 cases, 3%), stroke (1 case, 1%), asymptomatic pulmonary vein stenosis (2 cases, 2%).
Conclusion: CPVA guided by 3-D mapping system can be performed in CAF patients with an acceptable efficacy, but safety need to be improved.