Key result
Local pulmonary vein capture after ablation links to ~2.4-fold higher odds of sinus rhythm maintenance.
Why the study?
The impact of local capture of the myocardium of the pulmonary veins after radiofrequency isolation on treatment effectiveness in paroxysmal atrial fibrillation was unclear.
Observational (n=186)
No
Local capture after PVI may mark durable isolation in paroxysmal AF; hypothesis-generating and needs randomized confirmation before practice change.
Aim . To study how the presence of local capture (LC) after pulmonary vein (PV) isolation affects the effectiveness of radiofrequency ablation (RFA) in patients with paroxysmal atrial fibrillation (AF) Methods . The study was a single-center, observational, prospective study. The total number of 186 patients. All patients underwent RFA PV for paroxysmal AF. During the operation, the activity of PV and the presence of LC were assessed. Patients in whom LC after PV isolation occurred in at least one PV were included in the first group; patients in whom LC were absent - in the second group. The first group - 98 patients, the second group - 88. Patients in the groups did not statistically differ in the main indicators - weight, gender, age, duration of anamnesis, left atrium volume and ejection fraction, as well as in the presence of concomitant pathology. The duration of the operation, the time of RFA and time fluoroscopy between the groups also did not differ statistically. Results . Mean observation time for patients was 374.4±25,.2 days. In the first group, sinus rhythm was maintained in 82 patients out of 98 (83,7%), in the second group 60 patients out of 88 (68.2%). The difference is statistically significant odds ratio 2.392 (95% confidence interval 1.189 - 4.816, p=0.031). Conclusion . The presence of local captures of the myocardium of the pulmonary veins after radiofrequency isolation is associated with an improvement in the results of treatment of patients with paroxysmal AF.
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Базылев et al. (2023) conducted an observational in Paroxysmal atrial fibrillation (n=186). Presence of local captures after pulmonary vein isolation vs. Absence of local captures after pulmonary vein isolation was evaluated on Maintenance of sinus rhythm (freedom from any atrial arrhythmia) (OR 2.392, 95% CI 1.189-4.816, p=0.031). The presence of local captures of the pulmonary vein myocardium after radiofrequency isolation was associated with a higher rate of sinus rhythm maintenance compared to its absence (83.7% vs 68.2%, OR 2.392).
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