Left Atrial Roof Line

Techniques evaluation and consequences of linear block at the left atrial roof in paroxysmal atrial fibrillation.

Left atrial roof line.

These lines include the la roof the posterior line and the mitral isthmus 6 12 still the role of additional lines remains controversial. Isolation of the pulmonary veins pvs for the treatment of atrial fibrillation af is often supplemented with linear lesions within the left atrium la. A prospective randomized study. That is doctors may make a lesion line along the roof of the left atrium and then pace or use a mapping catheter to determine whether conduction has been stopped.

The left atrial line is a single lumen catheter unlike the right atrial line which is double lumen. 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. They described the phenomenon of intra atrial conduction block in a subset of patients undergoing ablation for left lateral accessory pathways. Surface electrocardiographic criteria to differentiate it from mitral annular ma flutters are lacking.

If there continues to be afib activity the doctor will ablate the next area in the sequence. 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. A left atrial isthmus was first described by luria et al.

Hocini m jais p sanders p takahashi y rotter m rostock t hsu lf sacher f reuter s clementy j haissaguerre m. 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. An irrigated ablation catheter is introduced with its tip oriented toward the la roof. 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.

However there are conflicting data on the effects of creating a roof line rl joining the superior pvs in paroxysmal atrial fibrillation paf. 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. 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.