alexa A new approach for complete isolation of the posterior left atrium including pulmonary veins for atrial fibrillation.


Arrhythmia: Open Access

Author(s): Kumagai K, Muraoka S, Mitsutake C, Takashima H, Nakashima H

Abstract Share this page


Esophageal injury is a potential complication after catheter ablation of the posterior left atrium (LA). Therefore, we describe a new approach for complete isolation of the posterior LA including all pulmonary veins (PVs) without vertical lesions along the esophageal aspect of the posterior LA, namely Box isolation.


Ninety-one patients with paroxysmal atrial fibrillation (AF) underwent Box isolation. Continuous lesions at the anterior portions of the ipsilateral PVs were initially created and then linear ablation of LA roof and bottom was performed to isolate the posterior LA. Continuous vertical lesions at the posterior portions of PVs along the esophageal aspect of the posterior LA were not created. Ablation was performed with an 8-mm-tip catheter. The endpoint was the absence of electrical activity and the inability to pace the posterior LA and all PVs in sinus rhythm. Complete isolation of the posterior LA was achieved in 82 patients (90%). Ablation resulted in the termination of AF in 65%, and subsequent noninducibility of AF in 71% of the patients. A repeat ablation was performed in six of nine patients with recurrence of arrhythmia. At 13 +/- 3 months of follow-up, 86 patients (95%) were arrhythmia-free without antiarrhythmic drugs.


This study shows that it is possible to achieve complete isolation of the posterior LA including all PVs without posterior vertical lesions. Box isolation is associated with a high clinical success rate.

This article was published in J Cardiovasc Electrophysiol. and referenced in Arrhythmia: Open Access

Relevant Expert PPTs

Relevant Speaker PPTs

  • Ishfaq A Bukhari
    Protective Effect of Diltiazem and Fenofibrate Against Ischemia-reperfusion Induced Cardiac Arrhythmias in the Isolated Rat Heart.
    PPT Version | PDF Version
  • Antonio Ferrari
    Spontaneous Ventricular Arrhythmias in Early Clinical Trials A Report from a Single and Repeated Ascending Dose Study
    PDF Version
  • Mohamed Chahine
    A novel mechanism of an SCN5A mutation causing mixed arrhythmias associated with dilated cardiomyopathy
    PDF Version
  • Saverio Gentile
    Ion channels phosphorylopathy: 3rd International Conference on Clinical & Experimental Cardiology April 15-17, 2013 A link between genomic variations and heart arrhythmia
    PDF Version
Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version