Normal Pulmonary Veins Anatomy is Associated with Better AF‐Free Survival after Cryoablation as Compared to Atypical Anatomy with Common Left Pulmonary Vein

Abstract

In patients undergoing cryoballoon PV isolation for AF, the presence of normal PVs pattern is associated with better AF-free survival as compared to atypical PV anatomy with CLPV, particularly in patients with paroxysmal AF.

Effect of left atrial volume and pulmonary vein anatomy on outcome of nMARQ™ catheter ablation of paroxysmal atrial fibrillation

“…They concluded that the ostial PV anatomy seems to have an important impact on clinical outcome and should be considered when planning and performing cryoballoon AF ablation procedures. Similarly Kubala et al [22] compared outcomes of cryoballoon ablation in AF patients with respect to the PV anatomy. The analysis found a better AF-free survival in patients with a "normal" PV anatomy.…”

Impact of pulmonary vein ostia anatomy on efficacy of cryoballoon ablation for atrial fibrillation

“…Some authors have reported that angulation may affect proper closure of the PV ostium by balloon [5] ; however, we did not examine this parameter in our study. The presence of a common trunk, usually on the left side, is regarded by some as an obstacle to obtain proper proximal PVI [3,4] whereas others did not find such a relationship [2] . Our finding that the area of the RSPV is greater than that of other PV is in line with the results of Guler et al [3] , who demonstrated that greater RSPV size was associated with more AF recurrences after ablation.…”

“…Due to the fact that the size and shape of the balloon are predefined, PV anatomy, including number of veins, presence of common trunk, angulation, ostium area and ovality, may have an impact on CB ablation efficacy. A few studies which addressed this issue provided inconsistent results [2][3][4][5][6] . Therefore, the aim of our study was to examine whether PV ostia anatomy is related to the acute and long-term effects of CB of AF.…”

Cryoballoon Ablation for Atrial Fibrillation

“…Although contentious, there are some reports suggesting that atypical PV anatomy such as common PV ostia may influence longer-term efficacy [18,36]. Kubala et al evaluated PV anatomic patterns in 118 consecutive patients with drug refractory paroxysmal (72%) or persistent (28%) AF [36]. The authors demonstrated that the presence of a normal PV pattern is associated with fewer recurrences of AF at 13 months of follow-up, when compared to patients with left common ostia (67% vs. 50%, P = 0.02).…”