Segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) are the two main approaches of radiofrequency ablation in patients with atrial fibrillation (AF).^1,2 The reported efficacy is between 60–90% depending on the approach and AF classification.^3–5

The goal of this retrospective study was to review our experience with both approaches, as well as patient outcome and safety of this new treatment.

METHODS

Between February 2001 and July 2003, 102 consecutive patients with paroxysmal or persistent AF were referred for ablation. The initial 28 patients underwent SPVI. From April 2002, 83 patients were treated with CPVI including nine patients with recurrence of AF after SPVI. We changed the approach due to a lower risk of potential pulmonary vein stenosis compared with SPVI and with an apparently comparable efficacy rate.² All patients were anticoagulated with warfarin before ablation. Transthoracic and transoesophageal echocardiography were performed to exclude structural heart disease and thrombus formation. SPVI and CPVI were performed according to the methods described by Haissaguerre et al¹ and Pappone et al.²

During the postablation follow up period patients received antiarrhythmic medication and warfarin for at least three months. Patients with recurrence of AF within three months were cardioverted or underwent …