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Received: 2003-03-03

Revision Accepted: 2003-03-28

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Journal of Zhejiang University SCIENCE A 2003 Vol.4 No.6 P.745-748

http://doi.org/10.1631/jzus.2003.0745


Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation


Author(s):  WANG Jian-an, SUN Yong, HE Hong

Affiliation(s):  Sir Run Run Shaw Hospital, Clinical Research Institute, Zhejiang University, Hangzhou 310016, China

Corresponding email(s):   wang_jian_an@163.net

Key Words:  Ultrasound ablation, Paroxysmal atrial fibrillation, Pulminary veins


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WANG Jian-an, SUN Yong, HE Hong. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation[J]. Journal of Zhejiang University Science A, 2003, 4(6): 745-748.

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author="WANG Jian-an, SUN Yong, HE Hong",
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doi="10.1631/jzus.2003.0745"
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T1 - Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation
A1 - WANG Jian-an
A1 - SUN Yong
A1 - HE Hong
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DOI - 10.1631/jzus.2003.0745


Abstract: 
Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation (AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60°C. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132±68 min for our patients. The average fluoroscopy time was 33±17 min. With a mean follow-up of 16±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

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Reference

[1]Chen, S.A., Hsieh, M.H., Tai, C.T.Tsai, C.F., Prakash, V.S., Yu, W.C.and Hsu, T.L., 1999.Initiation of atrial fibrillation by ectopic beats origination from the pulmonary veins: electrophysiological characteristics, pharmacological responses, and effects of radiofrequency ablation.Circulation, 100:1879-1881.

[2]Haissaguerre, M., Jais, P., Shah, D.C., Takahashi, A., Hocini, M., Quiniou, G., Garrigue, S., Le Mouroux, A., Le Metayer, P.and Clementy, J., 1998.Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.N Engl J Med, 339:659-664.

[3]Haissaguerre, M., Jais, P., Shah, D.C., Garrigue, S., Takahashi, A., Lavergne, T., Hocini, M., Peng, J.T., Roudant, R.and Chementy, J., 2000a.Electrophysiological end point for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci.Circulation, 101(12):1409-1417.

[4]Haissaguerre, M., Shah, D.C., Jais, P., Hocini, M., Yamane, T., Deiseihofer, I., Chauvin, M., Garrigue, S.and clementy, J., 2000b.Electrophysiological breakthroughs from the left atrium to the pulmonary veins.Circulation, 102(20):2463-2465.

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