Right Ventricular Septal Versus Right Ventricular Apical Pacing and Subsequent Development of Heart Failure—A Single Centre Experience

Abstract

roof line was performed only if venous lesion sets were sufficiently close. Patients were cardioverted to SR, if required. Further linear ablation was only performed if SR could not be maintained. Antiarrhythmic drugs were continued if possible. Postprocedure, recurrent persistent atrial tachyarrrhythmias (AT) were cardioverted within 48h of detection. Redo catheter ablation was considered if arrhythmias were detected beyond 3 months. Results: Consecutive patients with persistent (29/47) or permanent (18/47) AF were included. Sixteen patients received a roof line and 1 a mitral isthmus line. 21/47 patients had recurrent early AT with 19/21 requiring cardioversions. At a follow-up time of 339± 160 days 96% (45/47) remain in SR with 66% free of AT including 79% (23/29) persistent and 44% (8/18) permanent. Redo ablations were performed in 1 persistent and 8 permanent patients. Linear ablation did not predict freedom from AT. Early arrhythmias did not predict late recurrence with 10/21 subsequently remaining arrhythmia-free. Conclusions: Pulmonary vein antral electrical isolation with antiarrhythmic drugs and timely cardioversions in the early post-procedural period may promote reverse atrial electrical remodelling in persistent forms of AF. Permanent AF was significantly more likely to require redo ablation. doi:10.1016/j.hlc.2010.06.926