Asian Cardiovasc Thorac Ann 2006;14:e24-e26
© 2006 Asia Publishing EXchange Ltd
Epicardial Pulmonary Vein Isolation Concomitant with Aortic Valve Replacement
Hidehito Endo, MD,
Hiroshi Kubota, MD,
Yutaka Hosoi, MD,
Masaya Sato, MD,
Shigeyuki Ishii, MD,
Kenichi Sudo, MD
Department of Cardiovascular Surgery, University of Kyorin, Tokyo, Japan
For reprint information contact: Hidehito Endo, MD Tel: 81 4 2247 5511 Fax: 81 4 2242 7587 Email: ehidehito@hotmail.com, 6-20-2, Sinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
| The first 300 words of the full text of this article appear below. |
Based on a report that paroxysmal atrial fibrillation (AF) can be triggered by ectopic beats in or close to the pulmonary vein (PV), pulmonary vein isolation has been used as a treatment for AF. We describe a technique of cryoablation for isolation of the left atrial posterior wall and the PV in a patient with AF undergoing concomitant aortic valve replacement. The patient remained in sinus rhythm at the follow-up point of 25 months.
 |
INTRODUCTION
|
|---|
Atrial fibrillation (AF) is the most common type of sustained cardiac arrhythmia, being present in approximately 2% of the general population and in 5–9% of those aged 60 years or greater. The arrhythmia is an independent risk factor for stroke and contributes to significant patient morbidity and mortality.1 Since 1991, the Cox-Maze procedure has been used for the surgical ablation of abnormal foci that may otherwise trigger or perpetuate AF.2 This procedure is typically performed during correction of a co-existing valvular abnormality. In 1998, Haïssaguerre reported that paroxysmal AF can be triggered by an ectopic beat in or close to the pulmonary veins.3 Although pulmonary vein (PV) isolation has been used for successful ablation of areas responsible for perpetuating atrial fibrillation, the technique has some specific disadvantages that make its use problematic. The present report describes a novel approach, called ‘left atrium and pulmonary vein isolation; epicardially’ (LAVIE),4 for the rapid and safe isolation of the PV in a patient with chronic AF undergoing aortic valve replacement.
|
CASE REPORT
|
|---|
A 68-year-old man was diagnosed with severe aortic valve stenosis and AF of unknown duration. On admission, physical examination revealed a systemic blood pressure of 90/50 mm Hg and a heart rate of 64 beats·min–1. On auscultation, a grade III/VI systolic ejection murmur was evident at the upper left sternal border. Echocardiography revealed concentric left ventricular hypertrophy and . . . [Full Text of this Article]
Copyright © 2006 by SAGE Publications
