Left Atrial Roof Line

Isolation of the pulmonary veins pvs for the treatment of atrial fibrillation af is often supplemented with linear lesions within the left atrium la.

Left atrial roof line.

An irrigated ablation catheter is introduced with its tip oriented toward the la roof. It is sometimes called sequential ablation because the additional ablation lines are performed in a specified order. The left atrial line enters from the left superior pulmonary vein and exits the far side of the chest. Technique for ablation of the left atrial roof the la roofline is a line of lesions joining the left and right superior pvs.

A left atrial la line monitors left atrial pressures acting as a surrogate for left ventricular function preload and afterload. The clinical at was a dual loop at with left atrial la roof dependent and anterior macro re entrant circuits and terminated by an la roof and left superior pv mitral annulus linear ablation. A prospective randomized study. These lines include the la roof the posterior line and the mitral isthmus 6 12 still the role of additional lines remains controversial.

Left atrial la roof dependent flutter is a common macroreentrant la tachycardia that involves the la roof and typically spins around ipsilateral pulmonary veins pvs. Surface electrocardiographic criteria to differentiate it from mitral annular ma flutters are lacking. Techniques evaluation and consequences of linear block at the left atrial roof in paroxysmal atrial fibrillation. 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.

A left atrial isthmus was first described by luria et al. 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. As a result of greater extension of atrial fibrosis 5 for this reason the creation of additional linear lesions in the left atrium la has been proposed. However there are conflicting data on the effects of creating a roof line rl joining the superior pvs in paroxysmal atrial fibrillation paf.

Hocini m jais p sanders p takahashi y rotter m rostock t hsu lf sacher f reuter s clementy j haissaguerre m. Another at with a tachycardia cycle length tcl of 240 ms was then induced. They described the phenomenon of intra atrial conduction block in a subset of patients undergoing ablation for left lateral accessory pathways.