Characteristics and Efficacy of Pulmonary Vein Antrum Isolation in Endurance Athletes with Atrial Fibrillation

概要

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Long-term sports activities have recently been paid attention to be a risk factor of atrial fibrillation (AF). This study aimed to examine the mechanism of the AF and efficacy of pulmonary vein antrum isolation (PVAI) for the AF in endurance athletes. Pulmonary vein antrum isolation (PVAI) alone using EnSite system was performed in 10 athletes (46±7 years, 5 with persistent and 5 with paroxysmal, 39±4 mm mean left atrial diameter). All patients complained of impaired exercise tolerance. Only 3 patients suffered from palpitations and the other 7 patients felt no other symptoms during rest or mild exertion. Antiarrhythmic drugs were not effective in all patients. During a 17±9 month follow-up, 8 patients (80%) had no recurrence without antiarrhythmic drugs after a single PVAI session. Two patients had recurrences after the single session in whom one patient underwent repeat PVAIs twice because AF recurrence resulting from the LA-PV reconnections occurred. The remaining patient was rendered AF free with previously ineffective antiarrhythmic drug after a single PVAI. Finally, all patients felt improvement in exercise tolerance after a final PVAI. No procedure related complication was noted. In conclusion, our results suggest that AF is originated from the pulmonary veins and PVAI can be an effective therapy in athletic patients with AF like non-athletic patients.