Estudio electrofisiológico y ablación de actividad eléctrica anormal en venas pulmonares de pacientes con fibrilación auricular paroxística idiopática

objective: to analyze the results of radiofrequency catheter ablation (rfca) of the pulmonary veins (pv) in patients with paroxysmal atrial fibrillation (paf). material and methods: we describe 14 patients (38± 12 years, interval 8-52; 11 men) with symptomatic paf, refractory to antiarrhythmic drugs. special mapping catheters were used and ablation was performed at the ostium/antrum of those veins with abnormal electrical activity (aea). results: aea in one or more pv was identified in 13 patients (86%); in one patient aea was also found in the superior vena cava (6.6%). one procedure was complicated by unstable ventricular tachycardia and was not finished. success was accomplished in 10, in 5 after the first ablation, in 4 after the second, and in one after a third procedure. one patient had pericarditis with a small pericardial effusion that did not require intervention. conclusions: rfca is a useful and relatively safe procedure for the treatment of paf and the only one with curative potential. the long-term rate of success (with or without antiarrhythmics) in this series was 71%. these results justify catheter ablation in selected patients with symptomatic paf unresponsive to medical treatment.