[Curative treatment of paroxysmal atrial fibrillation with radiofrequency ablation]

Atrial fibrillation is associated with increased morbidity and twice the mortality compared to individuals without fibrillation. Treatment with antiarrhythmic drugs has limited effect in paroxysmal atrial fibrillation.

The group of patients comprised 59 men and 13 women with an average age of 51 +/- 10, the majority of whom had failed several drug regimens; some had undergone repeated DC conversions. A new method based on radiofrequency ablation and isolation of pulmonary veins from the left atrium may offer curative treatment for paroxysmal atrial fibrillation. The basis for this method is that foci in or close to the pulmonary veins initiate or drive atrial fibrillation. These foci may be identified by transseptal access to the left atrium and isolation of the veins from the left atrium using radiofrequency energy.

The group of 72 patients underwent 86 procedures. Foci were observed in 65.3%. Isolation of 3.1 +/- 0.9 veins was performed in 71 patients. During a follow up period of 10.3 +/- 5.1 months, 60.9% reported absence of fibrillation and 81.2% reported cure or considerable improvement. Complications included drainage of pericardial effusion in one patient, cerebral embolus with partial visual impairment in one patient, and an asymptomatic pulmonary vein stenosis in one patient.

Paroxysmal atrial fibrillation can be treated in selected patients using pulmonary vein isolation with low to moderate risk of complications. Longer follow up is necessary for full evaluation of effect.