Pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?

Introduction. Pulmonary vein isolation (PVI) by antral circumferential ablation is the standard procedure for patients with symptomatic and drug-refractory paroxysmal atrial fibrillation (AF). In some patients addition of ganglionated plexi (GP) modification in anatomic locations to PVI...

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Main Authors: Dinčić Dragan, Gudelj Ognjen, Đurić Ivica, Marinković Milan
Format: Article
Language:English
Published: Military Health Department, Ministry of Defance, Serbia 2017-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600081D.pdf
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author Dinčić Dragan
Gudelj Ognjen
Đurić Ivica
Marinković Milan
author_facet Dinčić Dragan
Gudelj Ognjen
Đurić Ivica
Marinković Milan
author_sort Dinčić Dragan
collection DOAJ
description Introduction. Pulmonary vein isolation (PVI) by antral circumferential ablation is the standard procedure for patients with symptomatic and drug-refractory paroxysmal atrial fibrillation (AF). In some patients addition of ganglionated plexi (GP) modification in anatomic locations to PVI confers significantly better outcomes than PVI alone. Case report. We reported a patient with paroxysmal, symptomatic AF and severe bradycardia a month prior to ablation. The patient was treated with antiarrhythmic drugs without success. Because of severe bradicardia the patient was implanted with a temporary pace maker two days before PVI. During PVI the decision was made to also do a modification of the left GP. Three months after the procedure the patients was in stable sinus rhythm without any symptoms. Conclusion. In selected patients with paroxysmal AF and pronounced vagal response PVI by circumferential antral ablation combined with GP modification during single ablation procedure can produce higher success rates than PVI or GP ablation alone.
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spelling doaj.art-93bd7d47f05f42dea775443ce731db302022-12-22T01:54:44ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202017-01-0174549850110.2298/VSP160212081D0042-84501600081DPulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?Dinčić Dragan0Gudelj Ognjen1Đurić Ivica2Marinković Milan3Military Medical Academy, Clinic for Emergency Internal Medicine, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Cardiology, BelgradeMilitary Medical Academy, Clinic for Cardiology, BelgradeClinical Center of Serbia, Clinic for Cardiology, BelgradeIntroduction. Pulmonary vein isolation (PVI) by antral circumferential ablation is the standard procedure for patients with symptomatic and drug-refractory paroxysmal atrial fibrillation (AF). In some patients addition of ganglionated plexi (GP) modification in anatomic locations to PVI confers significantly better outcomes than PVI alone. Case report. We reported a patient with paroxysmal, symptomatic AF and severe bradycardia a month prior to ablation. The patient was treated with antiarrhythmic drugs without success. Because of severe bradicardia the patient was implanted with a temporary pace maker two days before PVI. During PVI the decision was made to also do a modification of the left GP. Three months after the procedure the patients was in stable sinus rhythm without any symptoms. Conclusion. In selected patients with paroxysmal AF and pronounced vagal response PVI by circumferential antral ablation combined with GP modification during single ablation procedure can produce higher success rates than PVI or GP ablation alone.http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600081D.pdfatrial fibrillationpulmonary veinscatheter ablationvagotomy
spellingShingle Dinčić Dragan
Gudelj Ognjen
Đurić Ivica
Marinković Milan
Pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?
Vojnosanitetski Pregled
atrial fibrillation
pulmonary veins
catheter ablation
vagotomy
title Pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?
title_full Pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?
title_fullStr Pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?
title_full_unstemmed Pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?
title_short Pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response: Is it enough?
title_sort pulmonary veins isolation in a patient with atrial fibrillation and pronounced vagal response is it enough
topic atrial fibrillation
pulmonary veins
catheter ablation
vagotomy
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600081D.pdf
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AT đuricivica pulmonaryveinsisolationinapatientwithatrialfibrillationandpronouncedvagalresponseisitenough
AT marinkovicmilan pulmonaryveinsisolationinapatientwithatrialfibrillationandpronouncedvagalresponseisitenough