Left Atrial Roof Ablation

Treatment for atrial fibrillation usually improves your symptoms such as fatigue and shortness of breath.

Left atrial roof ablation.

Of the several proposed linear lesions only mitral isthmus and roof line ablation remain commonly performed as an adjunct to pulmonary vein isolation in the treatment of atrial fibrillation 2 3. Acute effects of left atrial radiofrequency ablation on atrial fibrillation. In fact cfae ablation has been shown to be less effective in stopping afib than a pulmonary vein antral isolation with additional lesion lines at the roof of the left atrium and along the mitral isthmus. A left atrial isthmus was first described by luria et al 4.

The idea that rapidly discharging atrial tachycardia foci usually located in the pulmonary veins could. 13 finally a randomized prospective trial comparing segmental pv isolation and circumferential pv ablation plus linear ablation at the la roof and mi showed that significantly. Methods betweenseptember2009andoctober2011 120consecutive patients admitted for a first catheter ablation for symptomatic drug refractory paroxysmalpafwereprospectivelyincludedin thestudy patients with any treatable cause of atrial fibrillation. Additional linear ablation was performed at the left atrial la roof to achieve bidirectional la roof conduction block.

Left atrial la roof dependent flutter is a common macroreentrant la tachycardia that involves the la roof and typically spins around ipsilateral pulmonary veins pvs. Left atrial la ablation for persistent atrial fibrillation af as performed in most electrophysiology laboratories in 2010 has developed from an amalgamation of several different approaches. Rarely it s the first choice of treatment for atrial fibrillation. Roofline ablation was performed at the most cranial part of the left atrium la with complete conduction block demonstrated during la appendage pacing by the online mapping of continuous double potential and an activation detour propagating around the pvs to activate caudocranially the posterior wall of the la.

3 to learn more see can catheter ablation successfully treat persistent atrial fibrillation which discusses a session at the heart rhythm society about ablating persistent afib. It has been suggested that ablation lines along the roof of the la and mitral isthmus may improve clinical outcomes in paf. 7 9 20 conversely the exclusion of the la posterior wall has no effect on the incidence of af recurrences after circumferential pv ablation in a randomized trial of 120 patients 60 in paf. Additional linear ablation was performed at the left atrial la lateral wall from the mitral annulus to the lpv anterior carine to achieve bidirectional la anterior block.

When left atrial ablation is performed during af the af may convert to atrial tachycardia or flutter in approximately 10 of patients. Atrial fibrillation ablation may be used if medications or other interventions to control an irregular heart rhythm don t work.