Impact of the Pulmonary Vein Orifice Area Assessed Using Intracardiac Echocardiography on the Outcome of Radiofrequency Catheter Ablation for Atrial Fibrillation

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2018 Feb 16

PMID 29445983

Citations 2

Authors

Takashi Nakashima

Masanori Kawasaki

Hiroyuki Toyoshi

Nobuhiro Takasugi

Tomoki Kubota

Hiromitsu Kanamori

Hiroaki Ushikoshi

Takuma Aoyama

Kazuhiko Nishigaki

Shinya Minatoguchi

Affiliations

Soon will be listed here.

Abstract

Purpose: The purposes of this study were to investigate pulmonary vein cross-sectional orifice area (PV-CSOA) using intracardiac echocardiography (ICE) and to determine its association with atrial fibrillation (AF) recurrence after radiofrequency catheter ablation (RFCA).

Methods: We studied 77 patients undergoing initial RFCA for AF (55 paroxysmal and 22 persistent AF patients, mean age 61 ± 12 years, 59 men). The PV-CSOA was measured in each patient and expressed as an index divided by the body surface area-left superior (LSPV-CSOA), left inferior (LIPV-CSOA), right superior (RSPV-CSOA), and right inferior (RIPV-CSOA).

Results: After a mean follow-up of 21 ± 14 months, 61 patients maintained sinus rhythm (non-recurrence group) and AF recurred in 16 patients (recurrence group). The LSPV-CSOA index was significantly greater in the recurrence group compared with the non-recurrence group (146 ± 41 vs. 126 ± 30 mm/m, p = 0.04). A Cox regression multivariate analysis revealed that the LSPV-CSOA was the independent predictor of AF recurrence (HR 1.02, 95% CI 1.01-1.04, p = 0.01). The LSPV-CSOA cutoff value of 154 mm/m predicts AF recurrence with 50% positive predictive value and 89% negative predictive value.

Conclusions: The present study suggests that ICE can be used as an alternative imaging tools for assessing the PV-CSOA during RFCA and that the LSPV-CSOA index was a useful independent predictor of AF recurrence after RFCA.

Citing Articles

Relationship between anatomical characteristics of pulmonary veins and atrial fibrillation recurrence after radiofrequency catheter ablation: a systematic review and meta-analysis.

Qi D, Zhang J Front Cardiovasc Med. 2023; 10:1235433.

PMID: 37795484 PMC: 10546190. DOI: 10.3389/fcvm.2023.1235433.

Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation.

Guckel D, Lucas P, Isgandarova K, El Hamriti M, Bergau L, Fink T J Interv Card Electrophysiol. 2022; 65(1):251-260.

PMID: 35764853 PMC: 9550688. DOI: 10.1007/s10840-022-01279-w.

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