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- Title
Impact of pulmonary vein anatomy and ostial dimensions on long-term outcome after single-shot device–guided cryoablation for paroxysmal atrial fibrillation.
- Authors
Isgandarova, Khuraman; Bergau, Leonard; El Hamriti, Mustapha; Braun, Martin; Piran, Misagh; Imnadze, Guram; Khalaph, Moneeb; Molatta, Stephan; Sciacca, Vanessa; Fink, Thomas; Sommer, Philipp; Guckel, Denise; Sohns, Christian
- Abstract
Background: Cryoballoon (CB)-guided pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF). This observational study aimed to assess the role of individual anatomical characteristics to predict long-term freedom from arrhythmia recurrence after CB-guided PVI for paroxysmal AF (PAF). Methods: Three hundred fifty three consecutive patients (58 ± 11 years, 56% males), undergoing PVI between 2012 and 2018 were analysed. Individual pulmonary vein (PV) anatomy was assessed using preprocedural cardiac magnetic resonance imaging (MRI). For each PV, the cross-sectional area (CSA) was calculated. The impact of PV characteristics and CSA on long-term AF-free survival was evaluated. Results: Acute PVI was achieved in all patients. Two hundred twenty-three patients (63%) had a normal PV anatomy (2 left- and 2 right-sided PV). Variant PV anatomy was present in 130 patients (37%). During the observation period of 48 months, AF-recurrence was documented in 167 patients (47 %). Patients with AF-recurrence presented with significantly enlarged right-sided PVs and left superior PVs (LSPVs) (p < 0.001). The presence of left common PVs (LCPVs) (n = 75, Log-rank p < 0.001) as well as right variant PVs (n = 35, Log rank p < 0.001) was associated with a significantly impaired long-term AF-free survival rate as compared to patients with normal PV characteristics. Conclusion: Variant PV anatomy is a good predictor for AF-recurrence. A correlation between an enlarged CSA of right-sided PVs as well as LSPVs and AF-recurrence was documented.
- Subjects
PULMONARY veins; ATRIAL fibrillation; CARDIAC magnetic resonance imaging; CRYOSURGERY; ANATOMY
- Publication
Journal of Interventional Cardiac Electrophysiology, 2023, Vol 66, Issue 9, p2125
- ISSN
1383-875X
- Publication type
Article
- DOI
10.1007/s10840-023-01554-4