Pulmonary vein anatomy addressed by computed tomography and relation to success of second‐generation cryoballoon ablation in paroxysmal atrial fibrillation. Issue 4 (13th March 2019)

• Record Type: Journal Article
• Authors: Mulder, Bart A.; Al‐Jazairi, Meelad I. H.; Arends, Bauke K. O.; Bax, Niels; Dijkshoorn, Leonard A.; Sheikh, Uzaifa; Tan, Eng S.; Wiesfeld, Ans C. P.; Tieleman, Robert G.; Vliegenthart, Rozemarijn; Rienstra, Michiel; van Gelder, Isabelle C.; Blaauw, Yuri
• Is Part Of: Clinical cardiology. Volume 42:Issue 4(2019)
• Page Start: 438
• Page End: 443
• Publication Date: 2019-03-13
• Subjects: anatomy -- atrial fibrillation -- computed tomography -- cryoballoon ablation -- outcome -- pulmonary veins; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.23163
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : Background: Cryoballoon isolation is considered a safe and effective treatment for atrial fibrillation (AF). However, recurrence of AF after first cryoballoon ablation occurs in ~30% of patients. Pre‐procedurally identifying patients at risk of AF recurrence could be beneficial. Hypothesis: Our aim was to determine how pulmonary vein (PV) anatomy influences the recurrence of AF using the second‐generation cryoballoon in patients with paroxysmal AF. Methods: We included 88 consecutive patients with paroxysmal AF undergoing PVI procedure with a second‐generation 28‐mm cryoballoon. All patients were evaluated at 3, 6 and 12 months using a 12‐lead ECG and 24‐hour Holter monitoring. PV anatomy was assessed by creating three‐dimensional models using computed tomography (CT) segmentations of the left atrium. Results: Fifty‐one patients (61%) had left PVs with a shared carina, 35 patients (42%) had a shared right carina. Nine patients (11%) were classified having a right middle PV. In total 17 (20.2%) of patients had a left common PV. At 12 months, 14 patients (17%) had experienced AF recurrence. Neither PV ovality, variant anatomy, the presence of shared carina nor a common left PV was a predictor for AF recurrence. Conclusions: No specific characteristics of PV dimensions nor morphology were associated with AF recurrence after cryoballoon ablation in patients with paroxysmal AF.