Single-Ring Isolation Connecting Four Ganglionated Plexi of the Posterior Left Atrium as an Alternative Procedure for Eliminating Atrial Fibrillation

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Background: Ganglionated plexus (GP) ablation is a novel approach in the treatment of atrial fibrillation (AF). We assessed whether our original approach i.e., combined procedure of single-ring isolation of the posterior left atrium and GP ablation on or near the ablation line is more successful than conventional ablation procedure for eliminating AF. Methods: We enrolled 38 consecutive patients with paroxysmal AF (average age 65±13 years, 24 men). Patients classified into two groups (groups A and B). Group A was defined as patients who underwent conventional extended pulmonary vein isolation procedure (E-PVI), and group B was defined as patients who underwent our original procedure. We compared clinical outcome between both groups. Results: Clinical features and the procedure time for ablation did not differ between both groups. During an observation period of 12.8±4.6 months, the maintenance of sinus rhythm was higher in group A than group B (98% vs. 90%, P=0.01). As regards the complication, a significant difference was not found between both groups. Conclusion: This study reveals the single-ring isolation connecting four GPs is more beneficial than conventional E-PVI. The advantage of our approach can create the isolation region without the vertical line of the posterior wall, which may injure the esophagus.
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