Key result
Larger right superior PV diameter predicts ~8% higher AF recurrence risk post-cryoballoon ablation.
Why the study?
Effective pulmonary vein isolation using cryoballoon ablation depends on adequate pulmonary vein occlusion, which may be influenced by pulmonary vein and left atrial anatomy.
Does pulmonary vein and left atrial anatomy predict atrial fibrillation recurrence and complications in patients undergoing cryoballoon ablation?
Does pulmonary vein and left atrial anatomy predict atrial fibrillation recurrence and complications in patients undergoing cryoballoon ablation?
Specific pulmonary vein anatomical features assessed by preprocedural CT independently predict atrial fibrillation recurrence and phrenic nerve injury after cryoballoon ablation.
Answers are grounded in this paper and cite their sources.
No takes yet. Share an insight, caveat, or question.
PV anatomy on preprocedural CT was associated with recurrence and phrenic injury risk; hypothesis-generating and requires prospective validation.
Background Effective pulmonary vein isolation (PVI) using cryoballoon (CB) ablation relies on adequate pulmonary vein (PV) occlusion, which may be influenced by PV and left atrial (LA) anatomy. Objectives To evaluate the impact of PV and LA anatomy, assessed by cardiac computed tomography (CT), on long‐term outcomes and complications following CB ablation for AF. Methods This retrospective study included 416 patients (54.8% female, mean age 57.5 ± 12.4 years) who underwent CB ablation for symptomatic AF. Paroxysmal AF was present in 87% and persistent AF in 13% of patients. Arctic Front Advance or Arctic Front Advance PRO catheters were used. All patients had preprocedural cardiac CT. AF recurrence and procedural complications were evaluated over a median follow‐up of 46.5 months (range: 6–116). Results Freedom from AF was observed in 73.1% of patients during follow‐up. Multivariable Cox regression analysis revealed that the maximum diameter of right superior PV (RSPV) (HR: 1.076, 95% CI: 1.003–1.154, p = 0.040) and the frontal angle of the left superior PV (LSPV) (HR:0.984, 95% CI: 0.968–0.999, p = 0.048) were independent predictors of recurrence. Independent predictors of phrenic nerve injury included the frontal angle of the RSPV (OR: 1.072, 95% CI: 1.020–1.126, p = 0.006) and the distance between the RSPV and the right phrenic nerve bundle (OR: 0.327, 95% CI: 0.188–0.579, p < 0.001). Conclusion Specific PV anatomical features influence AF recurrence and PNI after CB ablation. Preprocedural cardiac CT may help tailor ablation strategies and optimize patient outcomes.
Keresteci et al. (2026) studied this question. Larger right superior PV diameter and specific PV angles independently predict AF recurrence, while RSPV angle and proximity to phrenic nerve predict nerve injury post-cryoballoon ablation.
Synapse has enriched 10 related papers. Consider them for comparative context: