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BACKGROUND This prospective clinical study evaluates the feasibility and efficacy of combined linear mitral isthmus ablation and pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). METHODS AND RESULTS One hundred consecutive patients (13 women; age 55+/-10 years) with drug-refractory, symptomatic paroxysmal AF underwent PV(More)
BACKGROUND Ablation of long-standing persistent atrial fibrillation (AF) is highly variable, with differing techniques and outcomes. OBJECTIVE The purpose of this study was to undertake a systematic review of the literature with regard to the impact of ablation technique on the outcomes of long-standing persistent AF ablation. METHODS A systematic(More)
Background—The identification of sites of dominant activation frequency during atrial fibrillation (AF) in humans and the effect of ablation at these sites have not been reported. Methods and Results—Thirty-two patients undergoing AF ablation (19 paroxysmal, 13 permanent) during ongoing arrhythmia were studied. Electroanatomic mapping was performed,(More)
BACKGROUND The modification of atrial fibrillation cycle length (AFCL) during catheter ablation in humans has not been evaluated. METHODS AND RESULTS Seventy patients undergoing ablation of prolonged episodes of AF were randomized to pulmonary vein (PV) isolation or additional ablation of the mitral isthmus. Mean AFCL was determined at a distance from the(More)
BACKGROUND Congestive heart failure and atrial fibrillation often coexist, and each adversely affects the other with respect to management and prognosis. We prospectively evaluated the effect of catheter ablation for atrial fibrillation on left ventricular function in patients with heart failure. METHODS We studied 58 consecutive patients with congestive(More)
BACKGROUND The relative contributions of different atrial regions to the maintenance of persistent atrial fibrillation (AF) are not known. METHODS Sixty patients (53 +/- 9 years) undergoing catheter ablation of persistent AF (17 +/- 27 months) were studied. Ablation was performed in a randomized sequence at different left atrial (LA) regions and comprised(More)
BACKGROUND Pulmonary-vein isolation is increasingly being used to treat atrial fibrillation in patients with heart failure. METHODS In this prospective, multicenter clinical trial, we randomly assigned patients with symptomatic, drug-resistant atrial fibrillation, an ejection fraction of 40% or less, and New York Heart Association class II or III heart(More)
BACKGROUND The long-QT and Brugada syndromes are important substrates of malignant ventricular arrhythmia. The feasibility of mapping and ablation of ventricular arrhythmias in these conditions has not been reported. METHODS AND RESULTS Seven patients (4 men; age, 38+/-7 years; 4 with long-QT and 3 with Brugada syndrome) with episodes of ventricular(More)
OBJECTIVES The purpose of this study was to characterize the occurrence of phrenic nerve injury (PNI) and its outcome after radiofrequency (RF) ablation of atrial fibrillation (AF). BACKGROUND It is recognized that extra-myocardial damage may develop owing to penetration of ablative energy. METHODS Between 1997 and 2004, 3,755 consecutive patients(More)
BACKGROUND There are no reports describing the technique, electrophysiological evaluation, and clinical consequences of complete linear block at roofline joining the superior pulmonary veins (PVs) in patients with paroxysmal atrial fibrillation (AF). METHODS AND RESULTS Ninety patients with drug-refractory paroxysmal AF undergoing radiofrequency ablation(More)