ArticleClinical cardiology2020
Mitral isthmus block is associated with favorable outcomes after reablation for long-standing persistent atrial fibrillation.
Article in Clinical cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 3 citations in OpenAlex.
- Chronic Effects of Vein of Marshall Ethanol Infusion on Pulmonary Vein and Mitral Isthmus Reconnection.Arrhythmia & electrophysiology review · 2025Article
- Simplified stepwise anatomical ablation strategy for mitral isthmus: efficacy, efficiency, safety, and outcome.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Impact of technical aspects of vein of Marshall ethanol infusion on mitral isthmus block for persistent atrial fibrillation ablation.Frontiers in cardiovascular medicine · 2022Article
- Mitral isthmus block is associated with favorable outcomes after reablation for long-standing persistent atrial fibrillation.Clinical cardiology · 2020Article
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Authors and funding
5 authors at 1 institution in 1 country.
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Abstract
backgroundMitral isthmus (MI) ablation was limited due to technical challenges in the index ablation for long-standing persistent atrial fibrillation (LPeAF). The role of adjunctive MI ablation was controversial. HYPOTHESIS: MI block could be achieved in most patients undergoing repeat LPeAF ablation and was associated with favorable clinical outcomes.
methodsOf 87 consecutively patients undergoing reablation for recurrent atrial tachyarrhythmias (ATa), 41 patients with residual MI conduction but without pulmonary vein reconnection or left atrial roof conduction were enrolled to treat recurrent atrial flutter (AFL) (n = 20) and AF (n = 21). After AFL ablation and AF cardioversion, MI conduction gaps (CGs) were mapped and closed.
resultsMI line was successfully blocked in 37 (90.2%) of 41 patients after closing 1.4 ± 0.5 CGs (31 endocardial CGs and 16 epicardial ones) in the initial MI lines. CGs were more often located at the endocardial sites close to the lateral ridge between left atrial appendage and left-sided PVs, midportion of MI and at the epicardial breakthroughs within coronary sinus. At the end of 16.0 ± 1.9 months' follow-up, 31 (83.8%) of 37 patients with MI block and 1 of 4 patients without MI block were free of further recurrence of ATa off anti-arrhythmic drugs. MI block was positively associated with ATa-free survival by Cox's regression analysis (hazard ratio [HR]: 0.012, 95% confidence interval [CI]: 0.000-0.456, P = .02).
conclusionsMI block could be achieved in the majority of patients during repeat ablation for LPeAF. MI block was associated with favorable clinical outcomes after LPeAF reablation.
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