FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 339:659-666 September 3, 1998 Number 10 Next

	Full Text PDF Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Atrial fibrillation, the most common sustained cardiac arrhythmia and a major cause of stroke, results from simultaneous reentrant wavelets. Its spontaneous initiation has not been studied.

Methods We studied 45 patients with frequent episodes of atrial fibrillation (mean [±SD] duration, 344±326 minutes per 24 hours) refractory to drug therapy. The spontaneous initiation of atrial fibrillation was mapped with the use of multielectrode catheters designed to record the earliest electrical activity preceding the onset of atrial fibrillation and associated atrial ectopic beats. The accuracy of the mapping was confirmed by the abrupt disappearance of triggering atrial ectopic beats after ablation with local radio-frequency energy.

Results A single point of origin of atrial ectopic beats was identified in 29 patients, two points of origin were identified in 9 patients, and three or four points of origin were identified in 7 patients, for a total of 69 ectopic foci. Three foci were in the right atrium, 1 in the posterior left atrium, and 65 (94 percent) in the pulmonary veins (31 in the left superior, 17 in the right superior, 11 in the left inferior, and 6 in the right inferior pulmonary vein). The earliest activation was found to have occurred 2 to 4 cm inside the veins, marked by a local depolarization preceding the atrial ectopic beats on the surface electrocardiogram by 106±24 msec. Atrial fibrillation was initiated by a sudden burst of rapid depolarizations (340 per minute). A local depolarization could also be recognized during sinus rhythm and abolished by radio-frequency ablation. During a follow-up period of 8±6 months after ablation, 28 patients (62 percent) had no recurrence of atrial fibrillation.

Conclusions The pulmonary veins are an important source of ectopic beats, initiating frequent paroxysms of atrial fibrillation. These foci respond to treatment with radio-frequency ablation.

Source Information

From the Hôpital Cardiologique du Haut-Lévêque, Ave. de Magellan, 33604 Bordeaux-Pessac, France, where reprint requests should be addressed to Dr. Haïssaguerre.

Full Text of this Article

This article has been cited by other articles:

• Lu, Z., Scherlag, B. J., Lin, J., Yu, L., Guo, J.-H., Niu, G., Jackman, W. M., Lazzara, R., Jiang, H., Po, S. S. (2009). Autonomic mechanism for initiation of rapid firing from atria and pulmonary veins: evidence by ablation of ganglionated plexi. Cardiovasc Res 0: cvp194v2-cvp194 [Abstract] [Full Text]  
• Kirchhof, P., Bax, J., Blomstrom-Lundquist, C., Calkins, H., Camm, A. J., Cappato, R., Cosio, F., Crijns, H., Diener, H.-C., Goette, A., Israel, C. W., Kuck, K.-H., Lip, G. Y.H., Nattel, S., Page, R. L., Ravens, U., Schotten, U., Steinbeck, G., Vardas, P., Waldo, A., Wegscheider, K., Willems, S., Breithardt, G. (2009). Early and comprehensive management of atrial fibrillation: Proceedings from the 2nd AFNET/EHRA consensus conference on atrial fibrillation entitled 'research perspectives in atrial fibrillation'. Europace 11: 860-885 [Full Text]  
• Takatsuki, S., Extramiana, F., Hayashi, M., Haggui, A., Messali, A., Milliez, P., Leenhardt, A., Cauchemez, B. (2009). High take-off left inferior pulmonary vein as an obstacle in creating a conduction block at the lateral mitral isthmus. Europace 11: 910-916 [Abstract] [Full Text]  
• Crandall, M. A., Bradley, D. J., Packer, D. L., Asirvatham, S. J. (2009). Contemporary Management of Atrial Fibrillation: Update on Anticoagulation and Invasive Management Strategies. Mayo Clin Proc. 84: 643-662 [Abstract] [Full Text]  
• Doisne, N., Maupoil, V., Cosnay, P., Findlay, I. (2009). Catecholaminergic automatic activity in the rat pulmonary vein: electrophysiological differences between cardiac muscle in the left atrium and pulmonary vein. Am. J. Physiol. Heart Circ. Physiol. 297: H102-H108 [Abstract] [Full Text]  
• Bertaglia, E., Bella, P. D., Tondo, C., Proclemer, A., Bottoni, N., De Ponti, R., Landolina, M., Bongiorni, M. G., Coro, L., Stabile, G., Russo, A. D., Verlato, R., Mantica, M., Zoppo, F. (2009). Image integration increases efficacy of paroxysmal atrial fibrillation catheter ablation: results from the CartoMergeTM Italian Registry. Europace 0: eup152v1-eup152 [Abstract] [Full Text]  
• Kirchhof, P., Bax, J., Blomstrom-Lundquist, C., Calkins, H., John Camm, A., Cappato, R., Cosio, F., Crijns, H., Diener, H.-C., Goette, A., Israel, C. W., Kuck, K.-H., Lip, G. Y.H., Nattel, S., Page, R. L., Ravens, U., Schotten, U., Steinbeck, G., Vardas, P., Waldo, A., Wegscheider, K., Willems, S., Breithardt, G. (2009). Early and comprehensive management of atrial fibrillation: executive summary of the proceedings from the 2nd AFNET-EHRA consensus conference 'research perspectives in AF'. Eur Heart J 0: ehp235v1-ehp235 [Abstract] [Full Text]  
• Forleo, G. B., Tondo, C. (2009). Atrial fibrillation: cure or treat?. Ther Adv Cardiovasc Dis 3: 187-196 [Abstract]  
• Lin, Y.-J., Tai, C.-T., Kao, T., Chang, S.-L., Lo, L.-W., Tuan, T.-C., Udyavar, A. R., Wongcharoen, W., Hu, Y.-F., Tso, H.-W., Tsai, W.-C., Chang, C.-J., Ueng, K.-C., Higa, S., Chen, S.-A. (2009). Spatiotemporal Organization of the Left Atrial Substrate After Circumferential Pulmonary Vein Isolation of Atrial Fibrillation. Circ Arrhythmia Electrophysiol 2: 233-241 [Abstract] [Full Text]  
• Sohara, H., Takeda, H., Ueno, H., Oda, T., Satake, S. (2009). Feasibility of the Radiofrequency Hot Balloon Catheter for Isolation of the Posterior Left Atrium and Pulmonary Veins for the Treatment of Atrial Fibrillation. Circ Arrhythmia Electrophysiol 2: 225-232 [Abstract] [Full Text]  
• Cappato, R., Calkins, H., Chen, S.-A., Davies, W., Iesaka, Y., Kalman, J., Kim, Y.-H., Klein, G., Natale, A., Packer, D., Skanes, A. (2009). Prevalence and causes of fatal outcome in catheter ablation of atrial fibrillation.. J Am Coll Cardiol 53: 1798-1803 [Abstract] [Full Text]  
• Anter, E., Jessup, M., Callans, D. J. (2009). Atrial Fibrillation and Heart Failure: Treatment Considerations for a Dual Epidemic. Circulation 119: 2516-2525 [Full Text]  
• Lellouche, N., Sacher, F., Wright, M., Nault, I., Brottier, J., Knecht, S., Matsuo, S., Lomas, O., Hocini, M., Haissaguerre, M., Jais, P. (2009). Usefulness of C-reactive protein in predicting early and late recurrences after atrial fibrillation ablation. Europace 11: 662-664 [Abstract] [Full Text]  
• Miyanaga, S., Yamane, T., Date, T., Tokuda, M., Aramaki, Y., Inada, K., Shibayama, K., Matsuo, S., Miyazaki, H., Abe, K., Sugimoto, K.-i., Mochizuki, S., Yoshimura, M. (2009). Impact of pulmonary vein isolation on the autonomic modulation in patients with paroxysmal atrial fibrillation and prolonged sinus pauses. Europace 11: 576-581 [Abstract] [Full Text]  
• de Asmundis, C., Chierchia, G. B., Sarkozy, A., Paparella, G., Roos, M., Capulzini, L., Muller Burri, S. A., Yazaki, Y., Brugada, P. (2009). Novel trans-septal approach using a Safe Sept J-shaped guidewire in difficult left atrial access during atrial fibrillation ablation. Europace 11: 657-659 [Abstract] [Full Text]  
• Oakes, R. S., Badger, T. J., Kholmovski, E. G., Akoum, N., Burgon, N. S., Fish, E. N., Blauer, J. J.E., Rao, S. N., DiBella, E. V.R., Segerson, N. M., Daccarett, M., Windfelder, J., McGann, C. J., Parker, D., MacLeod, R. S., Marrouche, N. F. (2009). Detection and Quantification of Left Atrial Structural Remodeling With Delayed-Enhancement Magnetic Resonance Imaging in Patients With Atrial Fibrillation. Circulation 119: 1758-1767 [Abstract] [Full Text]  
• Kaab, S., Darbar, D., van Noord, C., Dupuis, J., Pfeufer, A., Newton-Cheh, C., Schnabel, R., Makino, S., Sinner, M. F., Kannankeril, P. J., Beckmann, B. M., Choudry, S., Donahue, B. S., Heeringa, J., Perz, S., Lunetta, K. L., Larson, M. G., Levy, D., MacRae, C. A., Ruskin, J. N., Wacker, A., Schomig, A., Wichmann, H.-E., Steinbeck, G., Meitinger, T., Uitterlinden, A. G., Witteman, J. C.M., Roden, D. M., Benjamin, E. J., Ellinor, P. T. (2009). Large scale replication and meta-analysis of variants on chromosome 4q25 associated with atrial fibrillation. Eur Heart J 30: 813-819 [Abstract] [Full Text]  
• Yilmaz, A., van Putte, B. P., Van Boven, W.-J. (2009). Reply to the Editor. J. Thorac. Cardiovasc. Surg. 137: 1036-1037 [Full Text]  
• Di Biase, L., Elayi, C. S., Fahmy, T. S., Martin, D. O., Ching, C. K., Barrett, C., Bai, R., Patel, D., Khaykin, Y., Hongo, R., Hao, S., Beheiry, S., Pelargonio, G., Russo, A. D., Casella, M., Santarelli, P., Potenza, D., Fanelli, R., Massaro, R., Wang, P., Al-Ahmad, A., Arruda, M., Themistoclakis, S., Bonso, A., Rossillo, A., Raviele, A., Schweikert, R. A., Burkhardt, D. J., Natale, A. (2009). Atrial Fibrillation Ablation Strategies for Paroxysmal Patients: Randomized Comparison Between Different Techniques. Circ Arrhythmia Electrophysiol 2: 113-119 [Abstract] [Full Text]  
• Holmes, D. R. Jr, Monahan, K. H., Packer, D. (2009). Pulmonary Vein Stenosis Complicating Ablation for Atrial Fibrillation: Clinical Spectrum and Interventional Considerations. J Am Coll Cardiol Intv 2: 267-276 [Abstract] [Full Text]  
• Balasubramaniam, R, Kistler, P M (2009). Atrial fibrillation in heart failure: the chicken or the egg?. Heart 95: 535-539 [Abstract] [Full Text]  
• Chierchia, G. B., de Asmundis, C., Muller-Burri, S.-A., Sarkozy, A., Capulzini, L., Paparella, G., Chierchia, S., Roos, M., Brugada, P. (2009). Early recovery of pulmonary vein conduction after cryoballoon ablation for paroxysmal atrial fibrillation: a prospective study. Europace 11: 445-449 [Abstract] [Full Text]  
• Oral, H., Chugh, A., Yoshida, K., Sarrazin, J. F., Kuhne, M., Crawford, T., Chalfoun, N., Wells, D., Boonyapisit, W., Veerareddy, S., Billakanty, S., Wong, W. S., Good, E., Jongnarangsin, K., Pelosi, F. Jr, Bogun, F., Morady, F. (2009). A randomized assessment of the incremental role of ablation of complex fractionated atrial electrograms after antral pulmonary vein isolation for long-lasting persistent atrial fibrillation.. J Am Coll Cardiol 53: 782-789 [Abstract] [Full Text]  
• Nademanee, K., Oketani, N. (2009). The role of complex fractionated atrial electrograms in atrial fibrillation ablation moving to the beat of a different drum.. J Am Coll Cardiol 53: 790-791 [Full Text]  
• Chun, K.-R. J., Schmidt, B., Metzner, A., Tilz, R., Zerm, T., Koster, I., Furnkranz, A., Koektuerk, B., Konstantinidou, M., Antz, M., Ouyang, F., Kuck, K. H. (2009). The 'single big cryoballoon' technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study. Eur Heart J 30: 699-709 [Abstract] [Full Text]  
• Shemin, R. J. (2009). Counterpoint: Minimally invasive bipolar radiofrequency ablation of lone atrial fibrillation: early multicenter results.. J. Thorac. Cardiovasc. Surg. 137: 527-528 [Full Text]  
• Peters, D. C., Wylie, J. V., Hauser, T. H., Nezafat, R., Han, Y., Woo, J. J., Taclas, J., Kissinger, K. V., Goddu, B., Josephson, M. E., Manning, W. J. (2009). Recurrence of atrial fibrillation correlates with the extent of post-procedural late gadolinium enhancement a pilot study.. J Am Coll Cardiol Img 2: 308-316 [Abstract] [Full Text]  
• McBride, B. F. (2009). The Emerging Role of Antiarrhythmic Compounds With Atrial Selectivity in the Management of Atrial Fibrillation. J Clin Pharmacol 49: 258-267 [Abstract] [Full Text]  
• Berntsen, R. F., Cheng, A., Calkins, H., Berger, R. D. (2009). Evaluation of spatiotemporal organization of persistent atrial fibrillation with time- and frequency-domain measures in humans. Europace 11: 316-323 [Abstract] [Full Text]  
• Friedlander, A. H., Yoshikawa, T. T., Chang, D. S., Feliciano, Z., Scully, C. (2009). Atrial Fibrillation: Pathogenesis, Medical-Surgical Management and Dental Implications. Journal of the American Dental Association 140: 167-177 [Abstract] [Full Text]  
• Tamborero, D., Mont, L., Berruezo, A., Matiello, M., Benito, B., Sitges, M., Vidal, B., de Caralt, T. M., Perea, R. J., Vatasescu, R., Brugada, J. (2009). Left Atrial Posterior Wall Isolation Does Not Improve the Outcome of Circumferential Pulmonary Vein Ablation for Atrial Fibrillation: A Prospective Randomized Study. Circ Arrhythmia Electrophysiol 2: 35-40 [Abstract] [Full Text]  
• Perez-Castellano, N, Villacastin, J, Salinas, J, Moreno, J, Doblado, M, Ruiz, E, Isa, R, Macaya, C (2009). Cooled ablation reduces pulmonary vein isolation time: results of a prospective randomised trial. Heart 95: 203-209 [Abstract] [Full Text]  
• Andrikopoulos, G., Tzeis, S., Maniadakis, N., Mavrakis, H. E., Vardas, P. E. (2009). Cost-effectiveness of atrial fibrillation catheter ablation. Europace 11: 147-151 [Abstract] [Full Text]  
• Mont, L., Elosua, R., Brugada, J. (2009). Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter. Europace 11: 11-17 [Abstract] [Full Text]  
• Kriatselis, C., Tang, M., Roser, M., Fleck, E., Gerds-Li, H. (2009). A new approach for contrast-enhanced X-ray imaging of the left atrium and pulmonary veins for atrial fibrillation ablation: rotational angiography during adenosine-induced asystole. Europace 11: 35-41 [Abstract] [Full Text]  
• Jais, P., Cauchemez, B., Macle, L., Daoud, E., Khairy, P., Subbiah, R., Hocini, M., Extramiana, F., Sacher, F., Bordachar, P., Klein, G., Weerasooriya, R., Clementy, J., Haissaguerre, M. (2008). Catheter Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation: The A4 Study. Circulation 118: 2498-2505 [Abstract] [Full Text]  
• Bajpai, A., Savelieva, I., Camm, A. J. (2008). Treatment of atrial fibrillation. Br Med Bull 0: ldn046v1-20 [Abstract] [Full Text]  
• Kistler, P. M., Rajappan, K., Harris, S., Earley, M. J., Richmond, L., Sporton, S. C., Schilling, R. J. (2008). The impact of image integration on catheter ablation of atrial fibrillation using electroanatomic mapping: a prospective randomized study. Eur Heart J 29: 3029-3036 [Abstract] [Full Text]  
• Dixit, S. (2008). Evolving Strategies in Catheter Ablation of Long-Standing Atrial Fibrillation. Circ Arrhythmia Electrophysiol 1: 324-326 [Full Text]  
• Rahmanian, P. B., Filsoufi, F., Salzberg, S., Coppolino, A., Castillo, J. G., Adams, D. H. (2008). Surgical treatment of atrial fibrillation using cryothermy in patients undergoing mitral valve surgery. ICVTS 7: 990-995 [Abstract] [Full Text]  
• Rostock, T., Steven, D., Hoffmann, B., Servatius, H., Drewitz, I., Sydow, K., Mullerleile, K., Ventura, R., Wegscheider, K., Meinertz, T., Willems, S. (2008). Chronic Atrial Fibrillation Is a Biatrial Arrhythmia: Data from Catheter Ablation of Chronic Atrial Fibrillation Aiming Arrhythmia Termination Using a Sequential Ablation Approach. Circ Arrhythmia Electrophysiol 1: 344-353 [Abstract] [Full Text]  
• Pytkowski, M., Jankowska, A., Maciag, A., Kowalik, I., Sterlinski, M., Szwed, H., Saumarez, R. C. (2008). Paroxysmal atrial fibrillation is associated with increased intra-atrial conduction delay. Europace 10: 1415-1420 [Abstract] [Full Text]  
• Yamada, T., Murakami, Y., Okada, T., McElderry, H. T., Doppalapudi, H., Epstein, A. E., Plumb, V. J., Murohara, T., Kay, G. N. (2008). Electroanatomic mapping in the catheter ablation of premature atrial contractions with a non-pulmonary vein origin. Europace 10: 1320-1324 [Abstract] [Full Text]  
• Chierchia, G. B., Capulzini, L., de Asmundis, C., Sarkozy, A., Roos, M., Paparella, G., Boussy, T., Van Camp, G., Kerkhove, D., Brugada, P. (2008). First experience with real-time three-dimensional transoesophageal echocardiography-guided transseptal in patients undergoing atrial fibrillation ablation. Europace 10: 1325-1328 [Abstract] [Full Text]  
• Malmborg, H., Lonnerholm, S., Blomstrom-Lundqvist, C. (2008). Acute and clinical effects of cryoballoon pulmonary vein isolation in patients with symptomatic paroxysmal and persistent atrial fibrillation. Europace 10: 1277-1280 [Abstract] [Full Text]  
• Knecht, S., Nault, I., Wright, M., Matsuo, S., Lellouche, N., Somasundaram, P. E., O'Neill, M. D., Lim, K.-T., Sacher, F., Deplagne, A., Bordachar, P., Hocini, M., Clementy, J., Haissaguerre, M., Jais, P. (2008). Imaging in catheter ablation for atrial fibrillation: enhancing the clinician's view. Europace 10: iii2-iii7 [Abstract] [Full Text]  
• Hauser, T. H., Peters, D. C., Wylie, J. V., Manning, W. J. (2008). Evaluating the left atrium by magnetic resonance imaging. Europace 10: iii22-iii27 [Abstract] [Full Text]  
• Knackstedt, C., Schauerte, P., Kirchhof, P. (2008). Electro-anatomic mapping systems in arrhythmias. Europace 10: iii28-iii34 [Abstract] [Full Text]  
• Niinuma, H., George, R. T., Arbab-Zadeh, A., Lima, J. A.C., Henrikson, C. A. (2008). Imaging of pulmonary veins during catheter ablation for atrial fibrillation: the role of multi-slice computed tomography. Europace 10: iii14-iii21 [Abstract] [Full Text]  
• Packer, D. L., Johnson, S. B., Kolasa, M. W., Bunch, T. J., Henz, B. D., Okumura, Y. (2008). New generation of electro-anatomic mapping: full intracardiac ultrasound image integration. Europace 10: iii35-iii41 [Abstract] [Full Text]  
• Saliba, W., Thomas, J. (2008). Intracardiac echocardiography during catheter ablation of atrial fibrillation. Europace 10: iii42-iii47 [Abstract] [Full Text]  
• Khan, M. N., Jais, P., Cummings, J., Di Biase, L., Sanders, P., Martin, D. O., Kautzner, J., Hao, S., Themistoclakis, S., Fanelli, R., Potenza, D., Massaro, R., Wazni, O., Schweikert, R., Saliba, W., Wang, P., Al-Ahmad, A., Beheiry, S., Santarelli, P., Starling, R. C., Russo, A. D., Pelargonio, G., Brachmann, J., Schibgilla, V., Bonso, A., Casella, M., Raviele, A., Haissaguerre, M., Natale, A., the PABA-CHF Investigators, (2008). Pulmonary-Vein Isolation for Atrial Fibrillation in Patients with Heart Failure. NEJM 359: 1778-1785 [Abstract] [Full Text]  
• Valles, E., Fan, R., Roux, J. F., Liu, C. F., Harding, J. D., Dhruvakumar, S., Hutchinson, M. D., Riley, M., Bala, R., Garcia, F. C., Lin, D., Dixit, S., Callans, D. J., Gerstenfeld, E. P., Marchlinski, F. E. (2008). Localization of Atrial Fibrillation Triggers in Patients Undergoing Pulmonary Vein Isolation: Importance of the Carina Region. J Am Coll Cardiol 52: 1413-1420 [Abstract] [Full Text]  
• Narayan, S. M., Kazi, D., Krummen, D. E., Rappel, W.-J. (2008). Repolarization and Activation Restitution Near Human Pulmonary Veins and Atrial Fibrillation Initiation: A Mechanism for the Initiation of Atrial Fibrillation by Premature Beats. J Am Coll Cardiol 52: 1222-1230 [Abstract] [Full Text]  
• McGann, C. J., Kholmovski, E. G., Oakes, R. S., Blauer, J. J.E., Daccarett, M., Segerson, N., Airey, K. J., Akoum, N., Fish, E., Badger, T. J., DiBella, E. V.R., Parker, D., MacLeod, R. S., Marrouche, N. F. (2008). New Magnetic Resonance Imaging-Based Method for Defining the Extent of Left Atrial Wall Injury After the Ablation of Atrial Fibrillation. J Am Coll Cardiol 52: 1263-1271 [Abstract] [Full Text]  
• Gaita, F., Caponi, D., Scaglione, M., Montefusco, A., Corleto, A., Di Monte, F., Coin, D., Di Donna, P., Giustetto, C. (2008). Long-Term Clinical Results of 2 Different Ablation Strategies in Patients With Paroxysmal and Persistent Atrial Fibrillation. Circ Arrhythmia Electrophysiol 1: 269-275 [Abstract] [Full Text]  
• Ishii, Y., Nitta, T., Kambe, M., Kurita, J., Ochi, M., Miyauchi, Y., Shimizu, K. (2008). Intraoperative verification of conduction block in atrial fibrillation surgery.. J. Thorac. Cardiovasc. Surg. 136: 998-1004 [Abstract] [Full Text]  
• Li, H., Li, Y., Sun, L., Liu, X., Xu, C., Han, J., Meng, X. (2008). Minimally Invasive Surgical Pulmonary Vein Isolation Alone for Persistent Atrial Fibrillation: Preliminary Results of Epicardial Atrial Electrogram Analysis. Ann. Thorac. Surg. 86: 1219-1225 [Abstract] [Full Text]  
• Geidel, S., Lass, M., Ostermeyer, J. (2008). A 5-year clinical experience with bipolar radiofrequency ablation for permanent atrial fibrillation concomitant to coronary artery bypass grafting and aortic valve surgery. ICVTS 7: 777-780 [Abstract] [Full Text]  
• Blaauw, Y, Crijns, H J G M (2008). Treatment of atrial fibrillation. Heart 94: 1342-1349 [Full Text]  
• Groh, M. A., Binns, O. A., Burton, H. G. III, Champsaur, G. L., Ely, S. W., Johnson, A. M. (2008). Epicardial Ultrasonic Ablation of Atrial Fibrillation During Concomitant Cardiac Surgery Is a Valid Option in Patients With Ischemic Heart Disease. Circulation 118: S78-S82 [Abstract] [Full Text]  
• Rahmanian, P. B., Castillo, J. G., Mehta, D., Adams, D. H., Filsoufi, F. (2008). Epicardial Pulmonary Vein Isolation: A Long-Term Histologic and Imaging Animal Study Comparing Cryothermy Versus Radiofrequency. Ann. Thorac. Surg. 86: 849-856 [Abstract] [Full Text]  
• Martignani, C., Diemberger, I., Biffi, M., Valzania, C., Bertini, M., Boriani, G. (2008). How to assess the efficacy of catheter ablation of atrial fibrillation?. Eur Heart J 29: 2183-2184 [Full Text]  
• De Piccoli, B., Rossillo, A., Zanella, C., Bonso, A., Themistoclakis, S., Corrado, A., Raviele, A. (2008). Role of transoesophageal echocardiography in evaluating the effect of catheter ablation of atrial fibrillation on anatomy and function of the pulmonary veins. Europace 10: 1079-1084 [Abstract] [Full Text]  
• Proclemer, A., Allocca, G., Gregori, D., Bonanno, C., Ometto, R., Fontanelli, A., Mantovan, R., Crosato, M., Calzolari, V., Pavoni, D., Facchin, D., Rebellato, L., Fioretti, P. M. (2008). Radiofrequency ablation of drug-refractory atrial fibrillation: an observational study comparing 'ablate and pace' with pulmonary vein isolation. Europace 10: 1085-1090 [Abstract] [Full Text]  
• Aliot, E., Ruskin, J. N. (2008). Controversies in ablation of atrial fibrillation. Eur Heart J Suppl 10: H32-H54 [Abstract] [Full Text]  
• Tan, A. Y., Zhou, S., Ogawa, M., Song, J., Chu, M., Li, H., Fishbein, M. C., Lin, S.-F., Chen, L. S., Chen, P.-S. (2008). Neural Mechanisms of Paroxysmal Atrial Fibrillation and Paroxysmal Atrial Tachycardia in Ambulatory Canines. Circulation 118: 916-925 [Abstract] [Full Text]  
• Onorati, F., Curcio, A., Santarpino, G., Torella, D., Mastroroberto, P., Tucci, L., Indolfi, C., Renzulli, A. (2008). Routine ganglionic plexi ablation during Maze procedure improves hospital and early follow-up results of mitral surgery.. J. Thorac. Cardiovasc. Surg. 136: 408-418 [Abstract] [Full Text]  
• Castella, M., Garcia-Valentin, A., Pereda, D., Colli, A., Martinez, A., Martinez, D., Ramirez, J., Mulet, J. (2008). Anatomic aspects of the atrioventricular junction influencing radiofrequency Cox maze IV procedures.. J. Thorac. Cardiovasc. Surg. 136: 419-423 [Abstract] [Full Text]  
• Klos, M., Calvo, D., Yamazaki, M., Zlochiver, S., Mironov, S., Cabrera, J.-A., Sanchez-Quintana, D., Jalife, J., Berenfeld, O., Kalifa, J. (2008). Atrial Septopulmonary Bundle of the Posterior Left Atrium Provides a Substrate for Atrial Fibrillation Initiation in a Model of Vagally Mediated Pulmonary Vein Tachycardia of the Structurally Normal Heart. Circ Arrhythmia Electrophysiol 1: 175-183 [Abstract] [Full Text]  
• Lu, Z., Scherlag, B. J., Lin, J., Niu, G., Fung, K.-M., Zhao, L., Ghias, M., Jackman, W. M., Lazzara, R., Jiang, H., Po, S. S. (2008). Atrial Fibrillation Begets Atrial Fibrillation: Autonomic Mechanism for Atrial Electrical Remodeling Induced by Short-Term Rapid Atrial Pacing. Circ Arrhythmia Electrophysiol 1: 184-192 [Abstract] [Full Text]  
• Satomi, K., Tilz, R., Takatsuki, S., Chun, J., Schmidt, B., Bansch, D., Antz, M., Zerm, T., Metzner, A., Kokturk, B., Ernst, S., Greten, H., Kuck, K.-H., Ouyang, F. (2008). Inducibility of atrial tachyarrhythmias after circumferential pulmonary vein isolation in patients with paroxysmal atrial fibrillation: clinical predictor and outcome during follow-up. Europace 10: 949-954 [Abstract] [Full Text]  
• Matiello, M., Mont, L., Tamborero, D., Berruezo, A., Benito, B., Gonzalez, E., Brugada, J. (2008). Cooled-tip vs. 8 mm-tip catheter for circumferential pulmonary vein ablation: comparison of efficacy, safety, and lesion extension. Europace 10: 955-960 [Abstract] [Full Text]  
• Shimano, M., Inden, Y., Tsuji, Y., Kamiya, H., Uchikawa, T., Shibata, R., Murohara, T. (2008). Circulating homocysteine levels in patients with radiofrequency catheter ablation for atrial fibrillation. Europace 10: 961-966 [Abstract] [Full Text]  
• Mangoni, M. E., Nargeot, J. (2008). Genesis and Regulation of the Heart Automaticity. Physiol. Rev. 88: 919-982 [Abstract] [Full Text]  
• Liang, L., Pan, Q., Liu, Y., Chen, H., Li, J., Brugada, R., Brugada, P., Hong, K., Perez, G. J., Zhao, C., Qi, J., Zhang, Y., Peng, L., Li, L., Chen, Y.-H. (2008). High sensitivity of the sheep pulmonary vein antrum to acetylcholine stimulation. J. Appl. Physiol. 105: 293-298 [Abstract] [Full Text]  
• Rostock, T., Steven, D., Lutomsky, B., Servatius, H., Drewitz, I., Klemm, H., Mullerleile, K., Ventura, R., Meinertz, T., Willems, S. (2008). Atrial fibrillation begets atrial fibrillation in the pulmonary veins on the impact of atrial fibrillation on the electrophysiological properties of the pulmonary veins in humans.. J Am Coll Cardiol 51: 2153-2160 [Abstract] [Full Text]