Key result
Segmental pulmonary vein isolation (OR 3.290) and lack of vagal denervation (high high-frequency component, OR 2.133) were independent predictors of late paroxysmal atrial fibrillation recurrence.
Why the study?
Does circumferential PVI compared to segmental PVI, and vagal modification, reduce late recurrence of paroxysmal atrial fibrillation?
Population
120 consecutive patients with paroxysmal atrial fibrillation undergoing successful pulmonary vein isolation.
Comparison
Circumferential pulmonary vein isolation (C-PVI) vs Segmental pulmonary vein isolation (S-PVI)
Design
Cohort
Follow-up
1-year
Authors
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These predictors may identify higher-risk patients post-ablation but should not change practice; leaves open whether targeting vagal denervation improves outcomes.
Cohort (n=120)
Yes
Does circumferential PVI compared to segmental PVI, and vagal modification, reduce late recurrence of paroxysmal atrial fibrillation?
Odds Ratio: 3.29 (95% CI 1.042–10.394)
Absolute Event Rate: 44% vs 21.6%
p-value: p=0.042
Vagal modification (assessed by heart rate variability) and the use of circumferential rather than segmental PVI are independent predictors of freedom from late paroxysmal atrial fibrillation recurrence.
Yamada et al. (2009) conducted a cohort in Symptomatic paroxysmal atrial fibrillation (n=120). Segmental pulmonary vein isolation (S-PVI) vs. Circumferential pulmonary vein isolation (C-PVI) was evaluated on Late paroxysmal atrial fibrillation recurrence at 1-year follow-up (OR 3.290, 95% CI 1.042-10.394, p=0.042). Segmental pulmonary vein isolation (OR 3.290) and lack of vagal denervation (high high-frequency component, OR 2.133) were independent predictors of late paroxysmal atrial fibrillation recurrence.
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