Mew technique for simultaneous catheter mapping of pulmonary veins for catheter ablation in focal atrial fibrillation

Introduction: Most focal atrial fibrillation (AF) can be triggered by prema ture beats from pulmonary veins (PVs), and ablation of these foci could cur e AF. However, it is difficult to locate the trigger points of PVs using on ly one mapping catheter. The purpose of the present study was to investigat e the efficacy of using four mapping catheters in four PVs simultaneously i n the ablation of focal AF, Methods and Results: Thirty-two patients with f requent attacks of paroxysmal AF triggered by PV foci were included. After a transseptal procedure, three 2-french microcatheters and one 7-french cat heter for ablation were placed into each of the PVs, and mapping of the fou r PVs was performed simultaneously. Fifty-eight foci were identified; 51 tr iggers (88%) originated from the PV and 7 (12%) from atrial tissue. The tri gger points of AF were found in a single focus in 14 patients, in 2 foci in 12 patients, and in 3-4 foci in 6 patients, During a mean follow-up period of in 10 +/- 4 months, ablation eliminated AF without drugs in 86, 50 and 33% of the patients with 4, 2 and 3-4 targeted PVs, respectively; 20 patien ts (63%) were successfully ablated. Age, history of AF, the dimension of th e left atrium and the number of focal origins were significant predictors o f success. Conclusion: The technique of simultaneous mapping of PVs using q uaruple catheters is a feasible and effective method for mapping the trigge r points and ablation of focal AF originating from PVs, Copyright (C) 2001 S. Karger AG, Basel.