Are specific left atrial anatomical features associated with first-pass pulmonary vein isolation success and long-term outcomes after cryoballoon ablation in patients with paroxysmal atrial fibrillation?
The absence of an orthogonal orientation of the left-sided pulmonary veins predicts lower first-pass isolation success and higher recurrence risk in patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation.
Background: Cryoballoon ablation is an established therapy for pulmonary vein (PV) isolation (PVI). Objective: This study aimed to explore whether specific left atrial anatomical features are associated with both first-pass PVI success and long-term outcomes after cryoballoon ablation using 2 different cryoablation systems. Methods: Left atrial reconstructions of patients with paroxysmal atrial fibrillation were analyzed. PVI was performed using either the Medtronic (Minneapolis, MN) Arctic Front Advance or the Boston Scientific (Marlborough, MA) POLARx cryoablation catheter. Anatomical features were assessed to predict first-pass PVI success after a single application and long-term outcomes on the basis of implantable cardiac monitor recordings. Results: < .001). Conclusion: The absence of an orthogonal orientation of the left-sided PVs was significantly associated with lower first-pass isolation rates and a higher risk of recurrence. These findings highlight the importance of preprocedural anatomical assessment to identify potential challenges and tailor ablation strategies.
Spreen et al. (Wed,) studied this question.
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