Effectiveness of Anterior Linear Ablation in Left Atria for Atrial Fibrillation in Swine AF Model

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Methods: We created a swine AF model using 3 weeks monensin administration to create atrial inflammation. At terminal surgery, an electrophysiological study was performed with the EnSite array system, and echocardiography was used to evaluate changes in cardiac function. Blood samples and cardiac tissues were assessed in 9 monensin-treated swine. In those with inducible AF, we created a linear ablation line in the anterior left atrium (LA) and evaluated the impact of linear ablation on episodes of paroxysmal AF. Results: Monensin created an AF substrate characterized by increased atrial but not ventricular fibrosis in swine. Monensin did not cause consistent changes in cardiac function, or plasma D-dimer or CRP levels. Electro-physiological study showed transverse conduction disturbances at the LA roof and anterior LA. In contrast, vertical conduction of LA during AF was almost simultaneous and no conduction disturbance was observed. Based on this observation, we created a linear ablation line at the roof of LA as well as at the anterior LA to LA appendage in 2 swine. AF was easily induced before, but not inducible after ablation. Conclusion: In this model, transverse conduction disturbance in the roof and anterior LA were critical for AF maintenance. Linear ablation that blocked transverse conduction in LA was very effective in preventing AF.