Las variantes anatómicas halladas fueron VP supernumerarias, todas con un vaso intermedio con su desembocadura en el lado derecho, y con menor frecuencia un tronco común en todos los casos izquierdo. Resultados: nuestra población en estudio presentaba un patrón de cuatro VP como característica anatómica más frecuente. Fueron excluidos quienes presentaban trombo en orejuela izquierda. Se compararon las imágenes obtenidas por RM y el sistema de navegación En Site. La población en estudio tenía una edad promedio de 58.2 años (rango: 21-82 años), y el 72.5% del total era de sexo masculino. Material y Métodos: estudio retrospectivo tipo caso control en el que se incluyeron 91 pacientes consecutivos con diagnóstico de FA en plan de ablación por RF entre julio de 2014 y Diciembre de 2017. Objetivo: determinar la utilidad de la Resonancia Magnética (RM) de la aurícula izquierda y venas pulmonares como parámetro anatómico de referencia para los sistemas de navegación en pacientes en plan de ablación por radiofrecuencia (RF) de FA. La ablación del antro de las venas pulmonares (VP) se ha convertido en el tratamiento de elección en pacientes con fibrilación auricular (FA) sintomática refractaria a fármacos. Conclusions: MR is an efficient, safe and simple tool which is highly precise in the evaluation of the anatomy of the left atrium and the PVs, so that its integration to navigation systems should be disseminated. The MR pulmonary veins anatomic analysis showed a substantial concordance with the EnSite navigation system, making the radiofrequency ablation planning easier. The common branch/ostium was the less usual variant, and it was left sided in all cases. Supernumerary PV was the anatomic variant found in the majority of cases, with all patients showing a right intermediate vein. Results: Our studied population presented more frequently an anatomic pattern of four PV. Patients with the presence of left atrial/appendage clot were excluded. MR and the EnSite navigation system imaging were compared. The studied population was a mean 58.2 years old (range: 21-82 years old), and 72.5% were men. Material and Methods: This is a retrospective case control study, which included 91 consecutive patients with AF diagnosis waiting for ablation between July 2014 and December 2017. Objective: To determine the usefulness of Magnetic Resonance (MR) of left atrial and pulmonary veins as reference anatomic parameter for navigation systems in patients who are going to be submitted to AF radiofrequency ablation. 22, pp.Nowadays, pulmonary veins (PV) ablation in patients with symptomatic drugs refractory atrial fibrillation (AF) has become the treatment of choice.
This may explain the excellent clinical outcomes using PVI alone, and may suggest an alternative ablation strategy for PersAF. A decline in Pdur in response to dofetilide was the only predictor of long-term clinical response to PVI in patients with PersAF.Conclusions: Pre-treatment with AAD resulted in a decrease in Pdur suggesting reverse atrial electrical remodeling in PersAF patients. The 6 and 12 mos AAD-free response to ablation was 76% and 70%, respectively, in PersAF patients, similar to the 80% and 75%, response in PAF patients (P = NS). 121.3 ± 13.7 ms, P = NS) was observed in PAF patients. In contrast, no change in Pdur (122.6 ± 11.5 ms vs.
In the PersAF patients, the Pdur decreased from 136.3 ± 21.7 ms (assessed postcardioversion on dofetilide) to 118.6 ± 20.4 ms (assessed immediately prior to PVI) (P < 0.001). All patients underwent PVI alone dofetilide was discontinued 1–3 mos postablation. Thirty-five patients with paroxysmal (P) AF not treated with an AAD served as controls. P-wave duration (Pdur) on ECG was used to assess reverse atrial remodeling. We hypothesized that preablation treatment of PersAF with a potent antiarrhythmic drug (AAD) would facilitate reverse atrial remodeling and result in high procedural efficacy after PVI alone.Methods and Results: Seventy-one consecutive patients (59.4 ± 9.8 years) with PersAF and prior AAD failure were treated with oral dofetilide (768 ± 291 mcg/day) for a median of 85 days pre-PVI. Introduction: Pulmonary vein isolation (PVI) alone has been thought to be insufficient in patients with persistent atrial fibrillation (PersAF). PVI Alone in Patients with Persistent AF.
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