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Indian Pacing Electrophysiol J. 2012 Jul;12(4):152-70. Epub 2012 Jul 28.

A review of mitral isthmus ablation.

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1
Oxford Heart Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.

Abstract

Mitral isthmus ablation forms part of the electrophysiologist's armoury in the catheter ablation treatment of atrial fibrillation. It is well recognised however, that mitral isthmus ablation is technically challenging and incomplete ablation may be pro-arrhythmic, leading some to question its role. This article first reviews the evidence for the use of adjunctive mitral isthmus ablation and its association with the development of macroreentrant perimitral flutter. It then describes the practical techniques of mitral isthmus ablation, with particular emphasis on the assessment of bi-directional mitral isthmus block. The anatomy of the mitral isthmus is also discussed in order to understand the possible obstacles to successful ablation. Finally, novel techniques which may facilitate mitral isthmus ablation are reviewed.

KEYWORDS:

ablation; atrial fibrillation; mitral isthmus

PMID:
22912536
PMCID:
PMC3407408
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