Catheter ablation of left atrial ganglionated plexi for atrial fibrillation

Asian Cardiovasc Thorac Ann. 2008 Jun;16(3):194-201. doi: 10.1177/021849230801600304.

Abstract

Radiofrequency ablation of pulmonary vein ostia does not provide complete and long-term elimination of atrial fibrillation. Combining this procedure with local radiofrequency application on sites with strong vagal reflexes results in partial parasympathetic denervation and increases the antiarrhythmic effect. A novel catheter-ablation technique to modify ganglionated plexi in the left atrium was assessed in 58 patients (mean age, 52.1 +/- 1.9 years, 67% male) with drug-refractory atrial fibrillation, which was chronic in 21 (36%; mean duration, 14.3 +/- 2.9 months; range, 5-39 months). The mean left atrial volume was 93.1 +/- 6.1 mL. The patients underwent ablation of 4 areas of ganglionated plexi in the left atrium, with no circumferential ablation of the pulmonary veins; atrial fibrillation ceased immediately in 94.1% of them. Transient vagal bradycardia was seen in 93% of patients. For 7.2 +/- 0.4 months after the procedure, 86.2% of them were free from arrhythmias, and no antiarrhythmic drugs were administered. Ganglionated plexi ablation is an efficient treatment for atrial fibrillation.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / methods*
  • Cohort Studies
  • Electrocardiography
  • Female
  • Ganglia, Sympathetic*
  • Heart Atria / innervation
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Treatment Outcome