کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5966142 | 1576157 | 2015 | 6 صفحه PDF | دانلود رایگان |

ObjectiveWe tested the hypothesis that pulmonary vein (PV) measurements on pre-procedural CT/MR imaging can predict difficulty in isolation and phrenic nerve (PN) injury during cryoballoon ablation for paroxysmal atrial fibrillation (AF).MethodsConsecutive patients with paroxysmal AF who had pre-procedural CT/MRI and underwent cryoballoon ablation as part of a randomized trial were studied. Imaging was anonymized for blinded analysis of: (1) maximum ostial diameter, (2) minimum ostial diameter, (3) ostial area and (4) ratio of maximum over minimum ostial diameter (eccentricity index). Veins that required more than 2 freezes of at least 200 s duration to isolate or not isolated were defined as difficult to isolate. Loss of PN pacing during right-sided ablation was defined as PN injury. Logistic regression was used to analyze the predictive effect of the measurements on the 2 outcomes.Results148 PVs in 38 patients (aged 60 ± 11 years, 76% male) were analyzed. Left inferior PV (LIPV) was most difficult to isolate with 23 out of 37 PVs (62%), and PN injury occurred in 3 of 38 (8%) right superior PV (RSPV). Greater eccentricity index predicted difficulty in isolating LIPV, OR 40.33 (95% CI 1.40 to 1160, p = 0.03) and smaller eccentricity index predicted PN injury in RSPV, OR 0.01 (95% CI 0.01-0.16, p = 0.001).ConclusionsEccentricity index measured from pre-procedural CT/MR imaging can predict difficulty of PV isolation and PN injury during cryoballoon ablation for paroxysmal AF.
Journal: International Journal of Cardiology - Volume 195, 15 September 2015, Pages 253-258