Electrophysiological end point for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci. Haissaguerre, M., Jais, P., Shah, D., Garrigue, S., Takahashi, A., Lavergne, T., Hocini, M., Peng, J., Roudaut, R., & Clementy, J. j-C, 101(12):1409--1417, 2000.
  author =       "M. Haissaguerre and P. Jais and D.C. Shah and S.
                 Garrigue and A. Takahashi and T. Lavergne and M. Hocini
                 and J.T. Peng and R. Roudaut and J. Clementy",
  title =        "Electrophysiological end point for catheter ablation
                 of atrial fibrillation initiated from multiple
                 pulmonary venous foci.",
  journal =      j-C,
  year =         "2000",
  volume =       "101",
  number =       "12",
  pages =        "1409--1417",
  robnote =      "BACKGROUND: The end point for catheter ablation of
                 pulmonary vein (PV) foci initiating atrial fibrillation
                 (AF) has not been determined. METHODS AND RESULTS:
                 Ninety patients underwent mapping during spontaneous or
                 induced ectopy and/or AF initiation. Ostial PV ablation
                 was performed by use of angiograms to precisely define
                 targeted sites. Success defined by elimination of AF
                 without drugs was correlated with the procedural end
                 point of the abolition of distal PV potentials. A total
                 of 197 arrhythmogenic PV foci (97\%)-single in 31\% and
                 multiple in 69\%-and 6 atrial foci were identified. A
                 discrete radiofrequency (RF) application eliminated the
                 PV potentials in 9 PV foci, whereas 2 foci from the
                 same PV required RF applications at separate sites in
                 19 cases. In others, a wider region was targeted with
                 progressive elimination of ectopy. In 49 patients,
                 multiple sessions were necessary owing to recurrent or
                 new ectopy. The clinical success rates were 93\%, 73\%,
                 and 55\% in patients with 1, 2, and > or =3
                 arrhythmogenic PV foci. Recovery of local PV potential
                 and the inability to abolish it were significantly
                 associated with AF recurrences (90\% success rate with
                 versus 55\% without PV potential abolition). PV
                 stenosis was noted acutely in 5 of 6 cases, remained
                 unchanged at restudy, and was associated with RF power
                 >45 W. CONCLUSIONS: Multiple PV foci are involved in
                 initiation of AF, and elimination of PV muscle
                 conduction is associated with clinical success.",
  bibdate =      "Sat Aug 11 10:47:17 2007",

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