Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation
BACKGROUND: Cryoballoon (CB)-guided pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF). This study aimed to evaluate ablation efficacy and freedom from arrhythmia recurrence using the novel POLARx compared to the Arctic Front Advance Pro (AFA) CB system including...
Published in: | Journal of Interventional Cardiac Electrophysiology |
---|---|
Main Authors: | , , , , , , , , , , , , |
Format: | Text |
Language: | English |
Published: |
Springer US
2022
|
Subjects: | |
Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550688/ http://www.ncbi.nlm.nih.gov/pubmed/35764853 https://doi.org/10.1007/s10840-022-01279-w |
id |
ftpubmed:oai:pubmedcentral.nih.gov:9550688 |
---|---|
record_format |
openpolar |
spelling |
ftpubmed:oai:pubmedcentral.nih.gov:9550688 2023-05-15T15:15:27+02:00 Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation Guckel, Denise Lucas, Philipp Isgandarova, Khuraman Hamriti, Mustapha El Bergau, Leonard Fink, Thomas Sciacca, Vanessa Braun, Martin Khalaph, Moneeb Imnadze, Guram Nölker, Georg Sommer, Philipp Sohns, Christian 2022-06-28 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550688/ http://www.ncbi.nlm.nih.gov/pubmed/35764853 https://doi.org/10.1007/s10840-022-01279-w en eng Springer US http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550688/ http://www.ncbi.nlm.nih.gov/pubmed/35764853 http://dx.doi.org/10.1007/s10840-022-01279-w © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . CC-BY J Interv Card Electrophysiol Article Text 2022 ftpubmed https://doi.org/10.1007/s10840-022-01279-w 2022-10-16T00:47:43Z BACKGROUND: Cryoballoon (CB)-guided pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF). This study aimed to evaluate ablation efficacy and freedom from arrhythmia recurrence using the novel POLARx compared to the Arctic Front Advance Pro (AFA) CB system including the analysis of individual PV characteristics. METHODS: A total of 687 patients underwent CB-guided ablation for AF. Arrhythmia recurrence was defined as an ECG documented episode of any AF/atrial tachycardia (AT) > 30 s. Anatomical characteristics were assessed using magnetic resonance imaging (MRI). For each PV, the cross-sectional orifice area (CSOA) was determined. Follow-up examinations were scheduled after 3, 6, and 12 months. RESULTS: Acute PVI was achieved in all patients. Twelve-month AF-free survival was similar between the groups (POLARx 43/86 (50%) vs. AFA 318/601 (53%), Log-rank (LR) p = 0.346). MRI found a comparable percentage of patients with normal PV anatomy (POLARx 71/86 (83%) vs. AFA 530/601 (85%), p = 0.162). Patients with variant PV characteristics presented with a significantly impaired 12-month AF-free survival (normal PVs 326/585 (56%) vs. variant PVs 27/102 (27%), LR p < 0.001) independent of the applied CB ablation system. PAF patients with AF recurrence presented with significantly larger CSOA of the left-sided PVs and the right superior PVs (LSPV: p < 0.001; LIPV: p < 0.001; RSPV: p < 0.001). In PERS AF, no association between CSOA and ablation outcome was observed. Multivariate analyses identified PERS AF (hazard ratio (HR) 2.504, confidence interval (CI), 1.900–3.299, p < 0.001) and variant PV anatomy (HR 2.124, CI 1.608–2.805, p < 0.001) as independent predictors for AF recurrence. CONCLUSIONS: Both CB ablation systems are associated with comparable 12-month AF-free survival rates. Variant PV anatomy seems to be predictive for AF recurrence. An association between CSOA and the outcome after CB-guided PVI was demonstrated for PAF. SUPPLEMENTARY INFORMATION: The ... Text Arctic PubMed Central (PMC) Arctic Journal of Interventional Cardiac Electrophysiology 65 1 251 260 |
institution |
Open Polar |
collection |
PubMed Central (PMC) |
op_collection_id |
ftpubmed |
language |
English |
topic |
Article |
spellingShingle |
Article Guckel, Denise Lucas, Philipp Isgandarova, Khuraman Hamriti, Mustapha El Bergau, Leonard Fink, Thomas Sciacca, Vanessa Braun, Martin Khalaph, Moneeb Imnadze, Guram Nölker, Georg Sommer, Philipp Sohns, Christian Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation |
topic_facet |
Article |
description |
BACKGROUND: Cryoballoon (CB)-guided pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF). This study aimed to evaluate ablation efficacy and freedom from arrhythmia recurrence using the novel POLARx compared to the Arctic Front Advance Pro (AFA) CB system including the analysis of individual PV characteristics. METHODS: A total of 687 patients underwent CB-guided ablation for AF. Arrhythmia recurrence was defined as an ECG documented episode of any AF/atrial tachycardia (AT) > 30 s. Anatomical characteristics were assessed using magnetic resonance imaging (MRI). For each PV, the cross-sectional orifice area (CSOA) was determined. Follow-up examinations were scheduled after 3, 6, and 12 months. RESULTS: Acute PVI was achieved in all patients. Twelve-month AF-free survival was similar between the groups (POLARx 43/86 (50%) vs. AFA 318/601 (53%), Log-rank (LR) p = 0.346). MRI found a comparable percentage of patients with normal PV anatomy (POLARx 71/86 (83%) vs. AFA 530/601 (85%), p = 0.162). Patients with variant PV characteristics presented with a significantly impaired 12-month AF-free survival (normal PVs 326/585 (56%) vs. variant PVs 27/102 (27%), LR p < 0.001) independent of the applied CB ablation system. PAF patients with AF recurrence presented with significantly larger CSOA of the left-sided PVs and the right superior PVs (LSPV: p < 0.001; LIPV: p < 0.001; RSPV: p < 0.001). In PERS AF, no association between CSOA and ablation outcome was observed. Multivariate analyses identified PERS AF (hazard ratio (HR) 2.504, confidence interval (CI), 1.900–3.299, p < 0.001) and variant PV anatomy (HR 2.124, CI 1.608–2.805, p < 0.001) as independent predictors for AF recurrence. CONCLUSIONS: Both CB ablation systems are associated with comparable 12-month AF-free survival rates. Variant PV anatomy seems to be predictive for AF recurrence. An association between CSOA and the outcome after CB-guided PVI was demonstrated for PAF. SUPPLEMENTARY INFORMATION: The ... |
format |
Text |
author |
Guckel, Denise Lucas, Philipp Isgandarova, Khuraman Hamriti, Mustapha El Bergau, Leonard Fink, Thomas Sciacca, Vanessa Braun, Martin Khalaph, Moneeb Imnadze, Guram Nölker, Georg Sommer, Philipp Sohns, Christian |
author_facet |
Guckel, Denise Lucas, Philipp Isgandarova, Khuraman Hamriti, Mustapha El Bergau, Leonard Fink, Thomas Sciacca, Vanessa Braun, Martin Khalaph, Moneeb Imnadze, Guram Nölker, Georg Sommer, Philipp Sohns, Christian |
author_sort |
Guckel, Denise |
title |
Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation |
title_short |
Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation |
title_full |
Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation |
title_fullStr |
Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation |
title_full_unstemmed |
Impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation |
title_sort |
impact of pulmonary vein variant anatomy and cross-sectional orifice area on freedom from atrial fibrillation recurrence after cryothermal single-shot guided pulmonary vein isolation |
publisher |
Springer US |
publishDate |
2022 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550688/ http://www.ncbi.nlm.nih.gov/pubmed/35764853 https://doi.org/10.1007/s10840-022-01279-w |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
J Interv Card Electrophysiol |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550688/ http://www.ncbi.nlm.nih.gov/pubmed/35764853 http://dx.doi.org/10.1007/s10840-022-01279-w |
op_rights |
© The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
op_rightsnorm |
CC-BY |
op_doi |
https://doi.org/10.1007/s10840-022-01279-w |
container_title |
Journal of Interventional Cardiac Electrophysiology |
container_volume |
65 |
container_issue |
1 |
container_start_page |
251 |
op_container_end_page |
260 |
_version_ |
1766345824291258368 |