Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral valve prostheses and enlarged atria
Safety, feasibility, and efficacy
Christopher C. Lang, MB, ChB,
Vincenzo Santinelli, MD,
Giuseppe Augello, MD,
Amedeo Ferro, MD,
Filippo Gugliotta, BEng,
Simone Gulletta, MD,
Gabriele Vicedomini, MD,
Cézar Mesas, MD,
Gabriele Paglino, MD,
Simone Sala, MD,
Nicoleta Sora, MD,
Patrizio Mazzone, MD,
Francesco Manguso, MD, PhD and
Carlo Pappone, MD, PhD*
Division of Cardiac Pacing and Arrhythmias, San Raffaele Hospital, Milan, Italy
View larger version (13K):
[in a new window]
|
Figure 1 Arrhythmic event-free survival for patients with and without prosthetic mechanical mitral valves. Patients have been stratified according to whether atrial fibrillation (AF) before ablation was paroxysmal (left panel) or chronic (middle panel). The right panel gives the results for all patients combined. Broken lines = mitral valve prosthesis (MVP); solid lines = no MVP.
|
|
View larger version (89K):
[in a new window]
|
Figure 2 Simultaneous images of catheter positions as seen on fluoroscopy and CARTO. The fluoroscopy helps establish the precise location of the mitral valve ring in relation to the CARTO map. CARTO has the advantage of being able to see the catheter tip position in multiple views simultaneously. However, with fluoroscopy, the valve leaflets are clearly visible, and contact between the catheter and the leaflets can be readily identified. The electrogram inset in the panels in the third column shows the typical appearance of a mitral annular electrogram recorded from the ablation catheter, whereas the inset just below it shows the characteristic artifact seen when the catheter is in contact with the mechanical leaflets.
|
|
|
