Identification of epicardial connections and ablation at earliest activation sites before PVI improved the success rate of first-pass right PVI (P<.05).
Observational (n=235)
Does a PVI strategy with identification and ablation of epicardial connections improve the success rate of first-pass right PVI in patients with atrial fibrillation?
Identifying and ablating epicardial connections around the right PV carina improves the success rate of first-pass right pulmonary vein isolation in patients with atrial fibrillation.
p-value: p=<.05
Background: Epicardial connections between the right pulmonary vein (PV) and the right atrium have been reported. Objective: The purpose of this study was to evaluate the usefulness of our new pulmonary vein isolation (PVI) strategy with identification of these epicardial connections. Methods: Overall, 235 patients with atrial fibrillation were included. High-density mapping of the left atrium was performed to identify the earliest activation sites (EASs) before PVI in all patients. With our new strategy, if EASs around the right PV carina were identified, we ablated these sites and performed usual first-pass circumferential PVI. The patients were divided into 2 groups according to the ablation strategy. One hundred fifteen patients underwent first-pass PVI without information on EASs (nonanalyzed group), and 78 patients underwent ablation at EASs around the right PV carina in addition to PVI (analyzed group). After first-pass ablation around the PV antrum, remapping was performed. Results: <.05). Conclusion: Identification of epicardial connections before ablation could improve the success rate of first-pass right PVI.
Wada et al. (Tue,) conducted a observational in Atrial fibrillation (n=235). Ablation at earliest activation sites (EASs) around the right PV carina in addition to PVI vs. First-pass PVI without information on EASs was evaluated on Success rate of first-pass right PVI (p=<.05). Identification of epicardial connections and ablation at earliest activation sites before PVI improved the success rate of first-pass right PVI (P<.05).