Non-regular pulmonary vein anatomy was associated with a significantly higher risk of atrial fibrillation recurrence after ablation using remote magnetic navigation (HR 1.72, P=0.04).
Cohort (n=138)
Does non-regular pulmonary vein anatomy predict atrial fibrillation recurrence after circumferential pulmonary vein ablation using remote magnetic navigation in patients with drug-refractory symptomatic AF?
Non-regular pulmonary vein anatomy assessed by MDCT is a significant predictor of increased AF recurrence following circumferential pulmonary vein ablation using remote magnetic navigation.
Effect estimate: HR 1.72
p-value: p=0.04
AIMS: Multidetector computed tomography (MDCT) is frequently used to guide circumferential pulmonary vein ablation (PVA) for treatment of atrial fibrillation (AF) as it offers accurate visualization of the left atrial (LA) and pulmonary vein (PV) anatomy. This study aimed to identify if PV anatomy is associated with outcomes following PVA using remote magnetic navigation (RMN). METHODS AND RESULTS: We analysed data from 138 consecutive patients and 146 ablation procedures referred for PVA due to drug-refractory symptomatic AF (age 63 ± 11 years; 57% men; 69% paroxysmal AF). The RMN using the stereotaxis system and open-irrigated 3.5 mm ablation catheters was used in all procedures. Prior to PVA, all patients underwent electrocardiogram-gated 64-MDCT for assessment of LA dimensions, PV anatomy, and electro-anatomical image integration during the procedure. Regular PV anatomy was found in 68%, a common left PV ostium was detected in 26%, and variant anatomy of the right PVs was detected in 6%. After a mean follow-up of 337 ± 102 days, 63% of the patients maintained sinus rhythm after the initial ablation, and 83% when including repeat PVA. Although acutely successful PV isolation did not differ between anatomical subgroups (regular 3.5 ± 0.8 vs. variant 3.2 ± 1.3; P = 0.31), AF recurrence was significantly higher in patients with non-regular PV anatomy (P = 0.04, hazard ratio 1.72). Pulmonary vein anatomy did not influence complication rates. CONCLUSION: Pulmonary vein anatomy assessed by MDCT is a good predictor of AF recurrence after PVA using RMN.
Sohns et al. (Tue,) conducted a cohort in Drug-refractory symptomatic atrial fibrillation (n=138). Circumferential pulmonary vein ablation using remote magnetic navigation vs. Regular vs non-regular pulmonary vein anatomy was evaluated on Atrial fibrillation recurrence (HR 1.72, p=0.04). Non-regular pulmonary vein anatomy was associated with a significantly higher risk of atrial fibrillation recurrence after ablation using remote magnetic navigation (HR 1.72, P=0.04).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: