Journal
CLINICAL CARDIOLOGY
Volume 41, Issue 1, Pages 74-80Publisher
WILEY
DOI: 10.1002/clc.22853
Keywords
Atrial Fibrillation; Catheter Ablation; Electrophysiological Techniques; Premature Atrial Contractions; Pulmonary Vein Isolation
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Funding
- Guangdong Provincial Science and Technology Program [2013B021800140]
- Guangzhou Science and Technology Project [201300000146]
- Southern Medical University Clinical Research Project [LC2016ZD002]
- President's Fund of Nanfang Hospital [2016B015]
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Background: We aimed to explore electrophysiological characteristics of premature atrial contractions (PACs) originating from pulmonary veins (PVs) and non-PVs and to evaluate the effectiveness and safety of catheter ablation for PACs. Hypothesis: Symptomatic PACs originated from different positions and whether could be ablated. Methods: Symptomatic, frequent, and drug-refractory PAC patients were enrolled in this study. All patients underwent electrophysiological study and catheter ablation. Results: A total of 81 patients were enrolled: 45 patients with PACs originating from PVs (group A), 24 patients with PACs originating from non-PVs (group B), and 12 patients with PACs arising from both PVs and non-PVs (group C). Twenty (44.4%) patients in group A, 6 (50.0%) patients in group C, and 3 (12.5%) patients in group B presented paroxysmal atrial fibrillation (P < 0.05). PV isolation was performed in groups A and C. Focal ablation or superior vena cava isolation was performed in groups B and C, depending on patient condition. PACs were abolished in all patients except one patient in group B. During a median follow-up period of 21.3 +/- 14.3 months, 40 (88.9%) patients in group A, 10 (83.3%) patients in group C, and 21 (87.5%) patients in group B were free of recurrence after initial ablation. Conclusions: Frequent PACs originating from PVs were associated with increased incidence of atrial fibrillation compared with PACs originating from non-PVs. Catheter ablation yields a satisfactory success rate and could be a good choice for eliminating symptomatic, frequent, and drug-refractory PACs.
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