--- abstract: "Atrial fibrillation (AF), the most common arrhythmia in adults, affects 1 in 25 people over the age of 60 years and 1 in 10 over the age of 80 years.1 There is considerable morbidity, mortality and economic burden associated with AF, all of which will increase with the expanding elderly population. Until recently, pharmacologic therapy with AV nodal blocking agents, antiarrhythmics and anticoagulation were the mainstay of therapy. Although electrical cardioversion is associated with a high immediate success rate, most patients have recurrences of AF with only 23% remaining in sinus rhythm one year after cardioversion.2 Antiarrhythmic agents have been shown to improve sinus maintenance, but these medications have variable success and are associated with many potentially serious side effects. In addition, the recently published AFFIRM trial suggests that a pharmacological rhythm control strategy has no benefit in terms of mortality or morbidity over a rate control and anticoagulation strategy.3 Over the last few years, there has been a great deal of enthusiasm regarding catheter based ablation strategies aimed at curing AF.\n" altloc: - http://www.ipej.org/0304/knight.htm chapter: ~ commentary: ~ commref: ~ confdates: ~ conference: ~ confloc: ~ contact_email: ~ creators_id: [] creators_name: - family: Gauri given: Andre J honourific: '' lineage: '' - family: Knight given: Bradley P honourific: '' lineage: '' date: 2003-10 date_type: published datestamp: 2005-04-20 department: ~ dir: disk0/00/00/42/46 edit_lock_since: ~ edit_lock_until: ~ edit_lock_user: ~ editors_id: [] editors_name: - family: Singh given: Balbir honourific: '' lineage: '' - family: Lokhandwala given: Yash honourific: '' lineage: '' - family: Francis given: Johnson honourific: '' lineage: '' - family: Gupta given: Anup honourific: '' lineage: '' eprint_status: archive eprintid: 4246 fileinfo: /style/images/fileicons/text_html.png;/4246/1/knight.htm full_text_status: public importid: ~ institution: ~ isbn: ~ ispublished: pub issn: ~ item_issues_comment: [] item_issues_count: 0 item_issues_description: [] item_issues_id: [] item_issues_reported_by: [] item_issues_resolved_by: [] item_issues_status: [] item_issues_timestamp: [] item_issues_type: [] keywords: 'Atrial Fibrillation; Catheter Ablation ' lastmod: 2011-03-11 08:55:58 latitude: ~ longitude: ~ metadata_visibility: show note: ~ number: 4 pagerange: 210-223 pubdom: TRUE publication: Indian Pacing and Electrophysiology Journal publisher: Indian Pacing and Electrophysiology Group refereed: TRUE referencetext: |- 1. Go AS, Hylek EM, Phillips KA et al. Prevalence of diagnosed atrial fibrillation in adults. JAMA 2001;285: 2370-5. 2. Falk RH. Atrial fibrillation. N Eng J Med 2001; 344:1067-78. 3. Wyse DG, Waldo AL, DiMarco JP et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Eng J Med 2002; 347: 1825-33. 4. Cox JL, Canavan TE Schuessler RB. The surgical treatment of atrial fibrillation. J Thorac Cardiovasc Surg 1991; 101:406-62 5. Sundt TM, Camillo CJ, Cox JL. The maze procedure for cure of atrial fibrillation. Cardiol Clin 1997;15:739-48 6. Avitall B, Urbonas A, Urboniene D. et al. Linear lesions provide protection from atrial fibrillation induction with rapid atrial pacing. J of Cardiovasc Electrophysiol 2002; 13:455-62. 7. Haines DE, Hummel JD, Knight BP, Moulton KP, and MECA Investigators: Linear atrial ablation with the multiple electrode catheter ablation (MECA) system for atrial fibrillation: Final report. Pacing Clin Electrophysiol 2002; 25: 637. 8. Haissaguerre M, Shah DC, Jais P et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Eng J Med 1998; 339:659-66. 9. Gerstenfeld EP, Guerra P, Sparks PB et al. Clinical outcomes after radiofrequency catheter ablation of focal atrial fibrillation triggers. J Cardiovasc Electrophysiol 2001; 12:900-8. 10. Chen SA, Hsieh MH, Tai TC, et al. Initiation of atrial fibrillation by ectopic beats originating from the pulmonary veins: Electrophysiological characteristics, pharmacologic response, and effects of radiofrequency ablation. Circulation 1999;100:1879-86. Medline Free Full Text 11. Haissaguerre M, Shah DC, Jais P et al. Electrophysiology breakthroughs from the left atrium to the pulmonary veins. Circulation 2000; 101:2463-65. Medline Free Full Text 12. Tada H, Oral H, Knight B, et al. Randomized comparison of bipolar versus unipolar plus bipolar recordings during segmental ostial ablation of pulmonary veins. J Cardiovasc Electrophysiol 2002; 13:851-6 13. Tada H, Oral H, Wasmer K et al. Pulmonary vein isolation: Comparison of Bipolar and Unipolar electrocardiograms at successful and unsuccessful ostial ablation site. . J Cardiovasc Electrophysiol 2002; 13:13-19 14. Oral H, Knight BP, Tada H, et al, Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation. Circulation 2002; 105: 1077-1081. Medline Free Full Text 15. Lin WS, Tai CT, Hsieh MH et al. Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy. Circulation 2003; 107:3176-83. 16. Scharf C, Sneider M, Case I, et al. Anatomy of the pulmonary veins in patients with atrial fibrillation and effects of segmental ostial ablation analyzed by computed tomography. J Cardiovasc Electrophysiol 2003; 14:150-155. 17. Saad EB, Marroche NF, Saad MD et al. Pulmonary vein stenosis after catheter ablation of atrial fibrillation: Emergence of a new clinical syndrome. Ann Intern Med 2003; 138:634-8. 18. Knight BP, Oral H, Chugh A et al. Effects of operator experience on the outcome and duration of pulmonary vein isolation procedures for atrial fibrillation. Am J Cardiol 2003; 91:673-77 19. Pappone C, Rosanio S, Oreto G et al. Circumferential radiofrequency ablation of pulmonary vein ostia. Circulation 2000; 102: 2619-28. Medline Free Full Text 20. Pappone C, Oreto G, Rosanio S et al. Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation. Circulation 2001; 104:2539-44. Medline Free Full Text relation_type: [] relation_uri: [] reportno: ~ rev_number: 8 series: ~ source: ~ status_changed: 2007-09-12 16:57:32 subjects: - ipej succeeds: ~ suggestions: ~ sword_depositor: ~ sword_slug: ~ thesistype: ~ title: Catheter Ablation for Atrial Fibrillation type: journalp userid: 4424 volume: 3