Catheter ablation approach on the right side only for paroxysmal atrial fibrillation therapy: Long-term results

We report the long-term follow-up of a right side only catheter ablation ap proach for paroxysmal AF. Eighteen patients with AF refractory to drugs ent ered the study. Ablation was attempted in the right atrium only by creating linear lesions based on a specific design including from two to four linea r lesions. Induction of AF a as attempted before ablation and after placeme nt of the lesions. ti septal lesion rt as performed in nine patients. In te n patients atrial defibrillation thresholds (ADFTs) before ablation and fol lowing creation of the linear lesions rr ere compared. After a mean follow- up of 22 +/- 22 months, seven patients had recurrence of AF, and another ni ne patients experienced atrial flutter or atrial tachycardia. Five patients remained in sinus rhythm without medications and four required the use of drugs. Three patients had sporadic AF and sh rr ere in chronic AF. The recu rrence rate was similar in patients with and without the septal lesion. How ever, a cure with right side ablation appeared to be predicted by the prese nce of disorganized and earlier activity in the high right atrium and crist a terminalis. Linear lesions in the right atrium were associated with a low er ADFT (pre 2.6 +/- 04 J vs post 1.7 +/- 0.6 J). In conclusion, in a small number of patients, control of AF can be obtained with a right side only a pproach. Certain activation patterns may identify patients suitable to this approach. No specific lesion pattern appeared more effective. Right atrial linear lesions resulted in lower ADFT.