?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Short-+and+long-term+experience+in+pulmonary+vein+segmental+ostial+ablation+for+paroxysmal+atrial+fibrillation*&rft.creator=P%C3%BCrerfellner%2C+H&rft.creator=Aichinger%2C+J&rft.creator=Martinek%2C+M&rft.creator=Nesser%2C+H.J&rft.creator=Janssen%2C+J&rft.subject=Indian+Pacing+and+Electrophysiology+Journal&rft.description=Introduction%3A+Segmental+ostial+pulmonary+vein++isolation+(PVI)+is+considered+a+potentially+curative+therapeutic+approach+in+the+treatment+of+paroxysmal+atrial+fibrillation+(PAF).+There+is+only+limited+data+available+on+the+long-term+effect+of+this+procedure.%0A%0AMethods%3A+Patients+(Pts)+underwent+a+regular+clinical+follow+up+visit+at+3%2C+6+and+24+months+after+PVI.+Clinical+success+was+classified+as+complete+(i.e.+no+arrhythmia+recurrences%2C+no+antiarrhythmic+drug)%2C+partial+(i.e.+no%2Fonly+few+recurrences%2C+on+drug)+or+as+a+failure+(no+benefit).+The+clinical+responder+rate+(CRR)+was+determined+by+combining+complete+and+partial+success.+%0A%0AResults%3A+117+patients+(96+male%2C+21+female)%2C+aged+51%C2%B111+years+(range+25+to+73)+underwent+a+total+of+166+procedures+(1.4%2Fpatient)+in+2-4+pulmonary+veins+(PV).+115+patients+(98%25)+had+AF%2C+2+patients+presented+with++regular+PV+atrial+tachycardia.+%2C109%2F115+patients.+exhibited+PAF+as+the+primary+arrhythmia+(versus+persistent+AF).+A+total+of+113+patients+with+PVI+in+the+years+2001+to+2003+were+evaluated+for+their+CRR+after+6+(3)+months.+A+single+intervention+was+carried+out+in+63+patients+(55.8%25)%2C+two+interventions+were+performed+in++45+patients+(39.8%25)+and+three+interventions+in+5+patients+(4.4%25).+The+clinical+response+demonstrated+a+complete+success+of++52%25+(59+patients)%2C+a+partial+success+of+26%25+(29+patients)+and+a+failure+rate+of+22%25+(25+patients)%2C+leading+to+a+CRR+of+78%25+(88+patients).+Ostial+PVI+in+all+4+PVs+exhibited+a+tendency+towards+higher+curative+success+rates+(54%25+versus+44%25+in+patients+with+3+PVs+ablated+for+the+6+month+follow+up).+Long-term+clinical+outcome+was+evaluated+in+39+patients+with+an+ablation+attempt+at+3+PVs+only+(excluding+the+right+inferior+PV+in+our+early+experience)+and+a+mean+clinical+follow+up+of++21%C2%B16+months.+At+this+point+in+time+the+success+rate+was+41%25+(complete%2C+16+patients)+and+21%25+(partial%2C+8+patients)%2C+respectively%2C+adding+up+to+a+CRR+of+62%25+(24+patients).+In+total%2C+20+patients+(17.1%25)+had+either+a+single+or+2+(3+patients%2C+2.6%25)+complications+independent+of+the+number+of+procedures+performed+with+PV+stenosis+as+the+leading+cause+(7.7%25).%0A+%0AConclusion%3A+The+CRR+of+patients+with+medical+refractory+PAF+in+our+patient+cohort+is+78%25+at+the+6+month+follow+up.+PV+stenosis+is+the+main+cause+for+procedure-related+complications.++Ablation+of+all+4+PV+exhibits+a+tendency+towards+higher+complete+success+rates+despite+equal+CRR.+Calculation+of+the+clinical+response+after+a+mid-+to+long-term+follow+of+21%C2%B16+months+in+those+patients+with+an+ostial+PVI+in+only+3+pulmonary+veins+(sparing+the+right+inferior+PV)+shows+a+further+reduction+to+62%25%2C+exclusively+caused+by+a+drop+in+patients+with+a+former+partial+success.++To+evaluate+the+long-term+clinical+benefit+of+segmental+ostial+PVI+in+comparison+with+other+ablation+techniques%2C+more+extended+follow+up+periods+are+mandatory%2C+including+a+larger+study+cohort+and+a+detailed+description+of+procedural+parameters.%0A&rft.publisher=Indian+Pacing+and+Electrophysiology+Group&rft.contributor=Singh%2C+Balbir&rft.contributor=Lokhandwala%2C+Yash&rft.contributor=Francis%2C+Johnson&rft.contributor=Gupta%2C+Anup&rft.date=2006-01&rft.type=Journal+(Paginated)&rft.type=PeerReviewed&rft.format=text%2Fhtml&rft.identifier=http%3A%2F%2Fcogprints.org%2F4672%2F1%2Fpurerfellner.htm&rft.format=application%2Fpdf&rft.identifier=http%3A%2F%2Fcogprints.org%2F4672%2F2%2Fpurerfellner.pdf&rft.identifier=++P%C3%BCrerfellner%2C+H+and+Aichinger%2C+J+and+Martinek%2C+M+and+Nesser%2C+H.J+and+Janssen%2C+J++(2006)+Short-+and+long-term+experience+in+pulmonary+vein+segmental+ostial+ablation+for+paroxysmal+atrial+fibrillation*.++%5BJournal+(Paginated)%5D+++++&rft.relation=http%3A%2F%2Fcogprints.org%2F4672%2F