Hybrid Epicardial and Endocardial Ablation of Persistent or Permanent Atrial Fibrillation: A New Approach for Difficult Cases

Background: Although percutaneous epicardial catheter ablation (PECA) has been used for the management of epicardial ventricular tachycardia, the use of PECA for atrial fibrillation (AF) has not yet been reported. Objective: To evaluate the efficacy and feasibility of a hybrid PECA and endocardial a...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2007-09, Vol.18 (9), p.917-923
Main Authors: PAK, HUI-NAM, HWANG, CHUN, LIM, HONG EUY, KIM, JIN SEOK, KIM, YOUNG-HOON
Format: Article
Language:English
Subjects:
atrial fibrillation
Atrial Fibrillation - surgery
catheter ablation
Catheter Ablation - methods
Combined Modality Therapy
Endocardium - surgery
epicardial ablation
Feasibility Studies
Female
Humans
Male
Middle Aged
Pericardium - surgery
Treatment Outcome
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Summary:Background: Although percutaneous epicardial catheter ablation (PECA) has been used for the management of epicardial ventricular tachycardia, the use of PECA for atrial fibrillation (AF) has not yet been reported. Objective: To evaluate the efficacy and feasibility of a hybrid PECA and endocardial ablation for AF. Methods: We performed PECA for AF in five patients (48.6 ± 8.1 years old, all male, four redo ablation procedures of persistent AF with a risk of pulmonary vein (PV) stenosis, one de novo ablation of permanent [AF]) after an endocardial AF ablation guided by PV potentials and 3D mapping (NavX). Utilizing an open irrigation tip catheter, a left atrial (LA) linear ablation from the roof to the perimitral isthmus or localized ablation at the junction between the LA appendage and left‐sided PVs or ligament of Marshall (LOM) was performed. Results: PECA of AF was successful in all patients with an ablation time of
ISSN:1045-3873
1540-8167
DOI:10.1111/j.1540-8167.2007.00882.x