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Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation
This article reviews methods for lesion set assessment during radiofrequency catheter ablation for atrial fibrillation (AF). Pulmonary vein isolation (PVI) is the foundation for AF ablation, but PV reconnection can lead to treatment failure. Testing for entrance block can help confirm PVI, although...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MediaSphere Medical
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252765/ https://www.ncbi.nlm.nih.gov/pubmed/32477766 http://dx.doi.org/10.19102/icrm.2017.080204 |
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author | Sze, Edward Bahnson, Tristram D. |
author_facet | Sze, Edward Bahnson, Tristram D. |
author_sort | Sze, Edward |
collection | PubMed |
description | This article reviews methods for lesion set assessment during radiofrequency catheter ablation for atrial fibrillation (AF). Pulmonary vein isolation (PVI) is the foundation for AF ablation, but PV reconnection can lead to treatment failure. Testing for entrance block can help confirm PVI, although complex electrograms that consist of both near- and far-field potentials may make assessment of entrance block challenging. Differential pacing maneuvers can help appropriately identify PV potentials. After entrance block has been achieved, pacing within the PVs to demonstrate capture of PV musculature with exit block may also help to confirm completeness of lesion sets for PVI. Employing a waiting period of at least 30 min or administering adenosine or isoproterenol can reveal dormant conduction, warranting adjunctive ablation. Additional techniques to confirm durable PVI include testing the ablation lines for excitability with high amplitude pacing, and automated waveform analysis of local electrogram morphology. Newer techniques like real-time magnetic resonance imaging and acoustic radiation force impulse elastography may have a role in testing the completeness of lesion sets in the future. |
format | Online Article Text |
id | pubmed-7252765 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MediaSphere Medical |
record_format | MEDLINE/PubMed |
spelling | pubmed-72527652020-05-28 Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation Sze, Edward Bahnson, Tristram D. J Innov Card Rhythm Manag Research Review This article reviews methods for lesion set assessment during radiofrequency catheter ablation for atrial fibrillation (AF). Pulmonary vein isolation (PVI) is the foundation for AF ablation, but PV reconnection can lead to treatment failure. Testing for entrance block can help confirm PVI, although complex electrograms that consist of both near- and far-field potentials may make assessment of entrance block challenging. Differential pacing maneuvers can help appropriately identify PV potentials. After entrance block has been achieved, pacing within the PVs to demonstrate capture of PV musculature with exit block may also help to confirm completeness of lesion sets for PVI. Employing a waiting period of at least 30 min or administering adenosine or isoproterenol can reveal dormant conduction, warranting adjunctive ablation. Additional techniques to confirm durable PVI include testing the ablation lines for excitability with high amplitude pacing, and automated waveform analysis of local electrogram morphology. Newer techniques like real-time magnetic resonance imaging and acoustic radiation force impulse elastography may have a role in testing the completeness of lesion sets in the future. MediaSphere Medical 2017-02-15 /pmc/articles/PMC7252765/ /pubmed/32477766 http://dx.doi.org/10.19102/icrm.2017.080204 Text en Copyright: © 2017 Innovations in Cardiac Rhythm Management http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Review Sze, Edward Bahnson, Tristram D. Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation |
title | Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation |
title_full | Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation |
title_fullStr | Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation |
title_full_unstemmed | Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation |
title_short | Pulmonary Vein Isolation Lesion Set Assessment During Radiofrequency Catheter Ablation for Atrial Fibrillation |
title_sort | pulmonary vein isolation lesion set assessment during radiofrequency catheter ablation for atrial fibrillation |
topic | Research Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7252765/ https://www.ncbi.nlm.nih.gov/pubmed/32477766 http://dx.doi.org/10.19102/icrm.2017.080204 |
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