Repeat ablation
Repeat ablation was more frequent in patients with LVAs (group B+C) than
those without (group A, Table 1). Median duration between the initial
and second ablation sessions was 10 (8, 16) months.
In the second ablation procedure, proportions of complete PV isolation,
defined as isolation of all 4 pulmonary veins from the left atrium, were
comparable between the groups,
namely
49% (23 of 46) patients in group A, 36% (5 of 14) in group B, 33% (3
of 9) in group C, and 50% (1 of 2, p = 0.73) in group D. All
reconnected PVs were successfully isolated.
During the repeat ablation procedure, a total of 31 regular ATs could
provide a complete activation map, developed spontaneously or by atrial
burst pacing, with higher frequency in patients with LVAs (group B+C)
than in those without LVA (group A, Figure 4A). Patients with LVA
ablation (group B) experienced regular ATs more frequently than those
without (group C). AT circuits determined by electroanatomical mapping
are demonstrated in Figure 4B. Ablation successfully eliminated 29 of 31
(93.5%) ATs. The remaining 2 ATs with failed ablation were biatrial
tachycardias observed in group B.
Ablation lesions throughout all ablation procedures are shown in Table
1. Patients with LVAs (group B+C) more frequently underwent extra PV
ablation than those without (group A). Patients in group B more often
received left atrial roof, bottom and anterior-septal linear ablations
than those in group C. In contrast, non-PV AF trigger ablation was more
frequent in group C than in group B.