Relation between Pulmonary Vein Firing and Extent of Left Atrial-Pulmonary Vein Connection in Patients with Atrial Fibrillation

Hiroshi Nakagawa, Hiroshi Aoyama, Karen J. Beckman, Sunny S. Po, Richard Wu, Deborah Lockwood, Peter Spector, James D. Calame, Daniel L. Lustgarten, Lisa Herring, Can Hasdemir, Dalip Singh, Ralph Lazzara, Warren M. Jackman

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background-The purpose of this study was to measure the extent of left atrial-pulmonary vein (LA-PV) connections and determine the relation to PV firing in patients with atrial fibrillation (AF). Methods and Results-Ten close-bipolar (1 mm-spacing) Lasso electrograms were recorded circumferentially around 210 PVs (excluding 2 right middle PVs and 4 left common trunks) in 62 patients with AF. PV firing was provoked by isoproterenol (4 μg/min) and cardioversion of pacing-induced AF. The width of each LA-PV connection was measured in tenths of PV circumference, based on number of continuous close-bipolar Lasso electrode sites required for ablation (10% for each close-bipolar electrode site). One, 2, or 3 to 4 discrete LA-PV connections (discrete connection defined by ablation along 10% to 30% of PV circumference) were present in 18 (9%), 31 (14%), and 32 (15%) of 210 PVs, respectively: 1 broad connection (ablation along continuous 40% to 80% circumference) in 46 (22%) PVs; 1 broad plus other broad or discrete connections in 54 (26%) PVs; and a circumferential connection (ablation along 90% to 100%) in 29 (14%) PVs. Circumferential LA-PV connections were more common in superior than in inferior PVs (20% versus 7%, P

Original languageEnglish (US)
Pages (from-to)1523-1529
Number of pages7
JournalCirculation
Volume109
Issue number12
DOIs
StatePublished - Mar 30 2004

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Pulmonary Veins
Atrial Fibrillation
Electrodes
Electric Countershock
Isoproterenol
alachlor

Keywords

  • Arrhythmia
  • Atrium
  • Catheter ablation
  • Fibrillation
  • Veins

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Relation between Pulmonary Vein Firing and Extent of Left Atrial-Pulmonary Vein Connection in Patients with Atrial Fibrillation. / Nakagawa, Hiroshi; Aoyama, Hiroshi; Beckman, Karen J.; Po, Sunny S.; Wu, Richard; Lockwood, Deborah; Spector, Peter; Calame, James D.; Lustgarten, Daniel L.; Herring, Lisa; Hasdemir, Can; Singh, Dalip; Lazzara, Ralph; Jackman, Warren M.

In: Circulation, Vol. 109, No. 12, 30.03.2004, p. 1523-1529.

Research output: Contribution to journalArticle

Nakagawa, H, Aoyama, H, Beckman, KJ, Po, SS, Wu, R, Lockwood, D, Spector, P, Calame, JD, Lustgarten, DL, Herring, L, Hasdemir, C, Singh, D, Lazzara, R & Jackman, WM 2004, 'Relation between Pulmonary Vein Firing and Extent of Left Atrial-Pulmonary Vein Connection in Patients with Atrial Fibrillation', Circulation, vol. 109, no. 12, pp. 1523-1529. https://doi.org/10.1161/01.CIR.0000121745.13435.E0
Nakagawa, Hiroshi ; Aoyama, Hiroshi ; Beckman, Karen J. ; Po, Sunny S. ; Wu, Richard ; Lockwood, Deborah ; Spector, Peter ; Calame, James D. ; Lustgarten, Daniel L. ; Herring, Lisa ; Hasdemir, Can ; Singh, Dalip ; Lazzara, Ralph ; Jackman, Warren M. / Relation between Pulmonary Vein Firing and Extent of Left Atrial-Pulmonary Vein Connection in Patients with Atrial Fibrillation. In: Circulation. 2004 ; Vol. 109, No. 12. pp. 1523-1529.
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AU - Nakagawa, Hiroshi

AU - Aoyama, Hiroshi

AU - Beckman, Karen J.

AU - Po, Sunny S.

AU - Wu, Richard

AU - Lockwood, Deborah

AU - Spector, Peter

AU - Calame, James D.

AU - Lustgarten, Daniel L.

AU - Herring, Lisa

AU - Hasdemir, Can

AU - Singh, Dalip

AU - Lazzara, Ralph

AU - Jackman, Warren M.

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AB - Background-The purpose of this study was to measure the extent of left atrial-pulmonary vein (LA-PV) connections and determine the relation to PV firing in patients with atrial fibrillation (AF). Methods and Results-Ten close-bipolar (1 mm-spacing) Lasso electrograms were recorded circumferentially around 210 PVs (excluding 2 right middle PVs and 4 left common trunks) in 62 patients with AF. PV firing was provoked by isoproterenol (4 μg/min) and cardioversion of pacing-induced AF. The width of each LA-PV connection was measured in tenths of PV circumference, based on number of continuous close-bipolar Lasso electrode sites required for ablation (10% for each close-bipolar electrode site). One, 2, or 3 to 4 discrete LA-PV connections (discrete connection defined by ablation along 10% to 30% of PV circumference) were present in 18 (9%), 31 (14%), and 32 (15%) of 210 PVs, respectively: 1 broad connection (ablation along continuous 40% to 80% circumference) in 46 (22%) PVs; 1 broad plus other broad or discrete connections in 54 (26%) PVs; and a circumferential connection (ablation along 90% to 100%) in 29 (14%) PVs. Circumferential LA-PV connections were more common in superior than in inferior PVs (20% versus 7%, P

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