Left Atrial Roof Line Ablation

Atrial fibrillation ablation is a procedure used to treat an irregular heart rhythm arrhythmia that starts in the heart s upper chambers atria.

Left atrial roof line ablation.

It has been suggested that ablation lines along the roof of the la and mitral isthmus may improve clinical outcomes in paf. They described the phenomenon of intra atrial conduction block in a subset of patients undergoing ablation for left lateral accessory pathways. A left atrial isthmus was first described by luria et al. If there continues to be afib activity the doctor will ablate the next area in the sequence.

1 this remnant of the fetal circulation can be used as route to the left atrium la during af ablation obviating the need for a transseptal puncture tsp with its associated risks. It is sometimes called sequential ablation because the additional ablation lines are performed in a specified order. Addition of linear ablation lesions principally in the atrial roof between the left and right superior pulmonary veins and mitral isthmus between the left inferior pulmonary vein and the mitral annulus led to improved success rates especially in patients with paroxysmal af and coexistent la enlargement and in patients with persistent af. Pre existing scar in the left atrium la can result in complex circuits sometimes with narrow channels that can be detected with high resolution mapping.

Background isolation of the pulmonary veins pvs for the treatment of atrial fibrillation af is often supplemented with linear lesions within the left atrium la. However there are conflicting data on the effects of creating a roof line rl joining the superior pvs in paroxysmal atrial fibrillation paf. About every fourth patient presenting for catheter ablation of atrial fibrillation af has a persistent foramen ovale pfo. Roofline ablation was performed at the most cranial part of the left atrium la with complete conduction block demonstrated during la appendage pacing by the online mapping of continuous double potential and an activation detour propagating around the pvs to activate caudocranially the posterior wall of the la.

That is doctors may make a lesion line along the roof of the left atrium and then pace or use a mapping catheter to determine whether conduction has been stopped. It s a type of cardiac ablation which works by scarring or destroying tissue in your heart to disrupt faulty electrical signals causing the arrhythmia. Of the several proposed linear lesions only mitral isthmus and roof line ablation remain commonly performed as an adjunct to pulmonary vein isolation in the treatment of atrial fibrillation 2 3.