The Importance of a Distance between the Lines Encircling Pulmonary Veins in Atrial Fibrillation Ablation on First-Pass Isolation Ratio and Clinical Outcomes

Krystian Krzyżanowski (), Marek Kiliszek, Beata Uziębło-Życzkowska, Magdalena Smalc-Stasiak, Aleksandra Winkler and Paweł Krzesiński
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Krystian Krzyżanowski: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
Marek Kiliszek: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
Beata Uziębło-Życzkowska: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
Magdalena Smalc-Stasiak: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
Aleksandra Winkler: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
Paweł Krzesiński: Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland

IJERPH, 2023, vol. 20, issue 7, 1-9

Abstract: Introduction: How wide the encircling line is made may influence the outcomes of pulmonary vein isolation (PVI). In the present study we hypothesised that the distance between the lines encircling the pulmonary veins may correspond with the extent of wide antral circumferential ablation (WACA). The aim of the study was to assess the impact of the distance and the area between the lines on the posterior wall of the left atrium on first-pass isolation rate and 12-month freedom from atrial arrhythmia in patients undergoing PVI ablation. Methods and results: One hundred sixteen patients underwent circumferential ablation index (AI)-guided PVI. The distance between the encircling ablation lines was measured off-line between the uppermost points (right and left) and the lowest points and as the area between the encircling lines on the posterior wall. The first-pass isolation rate and 12-month freedom from atrial arrhythmia were 59% and 73%, respectively. Distance between the encircling lines measured linearly or as the area of the posterior wall, assessed as direct values or indexed to left atrial dimensions, did not differ between patients with and without first-pass isolation or between patients with and without recurrences of atrial arrhythmia. Conclusions: The distance between the ablation lines did not influence the rate of first-pass isolation and arrhythmia recurrence in the long-term follow-up after PVI procedures incorporating the ablation index protocol.

Keywords: ablation; atrial fibrillation; pulmonary vein isolation; posterior wall; wide antral circumferential ablation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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