Key result
Larger PV diameter is linked to AF recurrence after RFCA.
Why the study?
The study sought to investigate the relationship between pulmonary vein anatomical characteristics, specifically diameter and cross-sectional orifices index, and atrial fibrillation recurrence following radiofrequency catheter ablation.
Does larger pulmonary vein diameter predict atrial fibrillation recurrence after radiofrequency catheter ablation?
Meta-Analysis (n=1,226)
Does larger pulmonary vein diameter predict atrial fibrillation recurrence after radiofrequency catheter ablation?
Effect estimate: MD 0.33 (95% CI 0.01, 0.66)
p-value: p=0.04
A larger mean pulmonary vein diameter is significantly associated with an increased risk of atrial fibrillation recurrence following radiofrequency catheter ablation.
May aid recurrence risk stratification after ablation; leaves open whether PV diameter should guide patient selection or technique.
Background The aim of the current study was to investigate the potential relationship between anatomical characteristics of pulmonary veins (PVs) and atrial fibrillation recurrence (AFR) following radiofrequency catheter ablation (RFCA), specifically focusing on PV diameter and cross-sectional orifices index (CSOA). The analysis was based on a comprehensive review of currently available literature, providing valuable insights for the prevention and treatment of AFR. Methods Data was collected from five databases, including PubMed, MEDLINE, EMBASE, and Cochrane, spanning the period from 2004 to October 2022. The search strategy utilized Medical Subject Headings (MeSH) terms related to PV diameter, PV size, PV anatomy, and AFR. Indicators of PV diameter and CSOA from the included studies were collected and analyzed, with Weight mean difference (WMD) and 95% confidence intervals (CIs) representing continuous variables. Results The meta-analysis included six studies. The results revealed that patients with AFR had a significant larger mean PV diameter compared to those without AFR (MD 0.33; 95% CI: 0.01, 0.66; P = 0.04; I 2 = 33.80%). In a meta-analysis of two studies involving a total of 715 participants, we compared the diameters of the left superior pulmonary vein (LSPV), left inferior pulmonary vein (LIPV), right superior pulmonary vein (RSPV), right inferior pulmonary vein (RIPV) between patients with AFR and patients without AFR. The results showed that there were no statistically significant differences between the two groups in any of the four data items (all P > 0.05). Additionally, the pooled estimate revealed that LSPV-CSOA, LIPV-COSA, RSPV-COSA, and RIPV-CSOA were greater in the AFR group compared to the non-AFR group, but the differences were not statistically significant (all P > 0.05). Conclusion We found evidence supporting the notion that the PV diameter of patients who experienced AFR after RFCA was significantly larger than that of patients without AFR. The findings suggested that the PV diameter could serve as a potential predictor of the risk of AFR following RFCA.
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Qi et al. (2023) conducted a meta-analysis in Atrial fibrillation (n=1,226). Atrial fibrillation recurrence (AFR) vs. Non-AFR was evaluated on Mean pulmonary vein (PV) diameter (MD 0.33, 95% CI 0.01, 0.66, p=0.04). Patients with atrial fibrillation recurrence after radiofrequency catheter ablation had a significantly larger mean pulmonary vein diameter compared to those without recurrence (MD 0.33).
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