Lasso Catheter Guided Ablation for Paroxysmal Atrial
Fibrillation : The First Experience in Thailand
ONGKARN RAUNGRA TANAAMPORN, MD*, KIERTUAI BHURIPPANYO, MD*,
CHUNHAKASEM CHOTINAIWATTARAKUL, MD**, SUTHISAK SUKSAP, BNS*,
ANNA CHIRAPASTAN, BNS*, NUNTA YA NINMANEECHOT,BNS*,
MALEE NUMEE, BNS*
Affiliation : * Bangkok Heart Institute, Bangkok Hospital, Bangkok 10320,
**Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractThe authors used the 10-pole pulmonary vein sized loop-shaped, lasso, catheter via a trans
atial septal long sheath in 10 patients who had symptomatic refractory paroxysmal atrial fibrillation
(PAF) in order to map and guide for catheter ablation. The radiofrequency current was delivered at
the junction between atrial tissue and the pulmonary vein which was the earliest endocardial activation
time of the premature atrial contraction (PAC) initiating the PAF and at the pulmonary vein potential
during sinus rhythm. Twenty two foci of PAC, 10 and 7, 4 and 1 from left and right superior and left
and right inferior pulmonary veins, respectively, and 5 pulmonary vein potentials, 2 and 3 from left
and right superior pulmonary veins, respectively, were ablated. After AF ablation, classical atrial flutter
(AFI) could be induced in 9 patients. Isthmus line of block for AFI was performed in all patients. Two
patients had atrial tachycardia at the high right atrium and also successfully ablated. The mean fluoro
scopic and procedure times were 87 and 300 minutes, respectively. One patient had deep vein thrombo
sis which resolved after anticoagulant therapy. One patient had recurrent PAF which was success
fully reablated but he still had very mild symptoms. During the mean follow-up period of 5.8 months,
9 patients remained free of symptoms.
Conclusion : Lasso catheter is an effective tool for mapping and guiding of ablation for PAF.
However, more experience and long-term follow-up are required.
Keywords : Pulmonary Vein Loop Catheter, Atrial Fibrillation, Ablation
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