Heart rhythm O2 · 2025
Impact of left atrial anatomy on pulmonary vein isolation with cryoballoon ablation: Insights from the randomized controlled COMPARE CRYO study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Spreen David, Kueffer Thomas, Iqbal Salik Ur Rehman, Badertscher Patrick, Maurhofer Jens, Krisai Philipp, Isenegger Corinne, Subin Behnam, Schärli Nicolas, Schaer Beat, Schlageter Vincent, Pradella Maurice, Jufer Corinne, Thalmann Gregor, Servatius Helge, Tanner Hildegard, Mahfoud Felix, Kühne Michael, Roten Laurent, Reichlin Tobias, Sticherling Christian, Knecht Sven
Аннотация
BACKGROUND: Cryoballoon ablation is an established therapy for pulmonary vein (PV) isolation (PVI).
OBJECTIVE: This study aimed to explore whether specific left atrial anatomical features are associated with both first-pass PVI success and long-term outcomes after cryoballoon ablation using 2 different cryoablation systems.
METHODS: Left atrial reconstructions of patients with paroxysmal atrial fibrillation were analyzed. PVI was performed using either the Medtronic (Minneapolis, MN) Arctic Front Advance or the Boston Scientific (Marlborough, MA) POLARx cryoablation catheter. Anatomical features were assessed to predict first-pass PVI success after a single application and long-term outcomes on the basis of implantable cardiac monitor recordings.
RESULTS: A total of 191 patients were enrolled (mean age 63.0 ± 9.8 years; 58 (30%) women). First-pass PVI was achieved in 69% of all procedures. Female sex was significantly associated with reduced first-pass isolation success, limited to the right superior PV (odds ratio [OR] 0.50; 95% confidence interval [CI] 0.26-0.97; P = .04). Anatomical predictors of failure of first-pass PVI included the absence of an orthogonal orientation of the left superior PV (OR 0.20; 95% CI 0.05-0.88; P = .033) and the left inferior PV (OR 0.36; 95% CI 0.13-0.99; P = .047) as well as the presence of a right middle PV for the right superior PV (OR 3.58; 95% CI 1.18-10.9; P = .024). The absence of an orthogonal orientation of the left superior PV was associated with atrial tachyarrhythmia recurrence (OR 4.12; 95% CI 1.90-9.11; P < .001).
CONCLUSION: The absence of an orthogonal orientation of the left-sided PVs was significantly associated with lower first-pass isolation rates and a higher risk of recurrence. These findings highlight the importance of preprocedural anatomical assessment to identify potential challenges and tailor ablation strategies.
OBJECTIVE: This study aimed to explore whether specific left atrial anatomical features are associated with both first-pass PVI success and long-term outcomes after cryoballoon ablation using 2 different cryoablation systems.
METHODS: Left atrial reconstructions of patients with paroxysmal atrial fibrillation were analyzed. PVI was performed using either the Medtronic (Minneapolis, MN) Arctic Front Advance or the Boston Scientific (Marlborough, MA) POLARx cryoablation catheter. Anatomical features were assessed to predict first-pass PVI success after a single application and long-term outcomes on the basis of implantable cardiac monitor recordings.
RESULTS: A total of 191 patients were enrolled (mean age 63.0 ± 9.8 years; 58 (30%) women). First-pass PVI was achieved in 69% of all procedures. Female sex was significantly associated with reduced first-pass isolation success, limited to the right superior PV (odds ratio [OR] 0.50; 95% confidence interval [CI] 0.26-0.97; P = .04). Anatomical predictors of failure of first-pass PVI included the absence of an orthogonal orientation of the left superior PV (OR 0.20; 95% CI 0.05-0.88; P = .033) and the left inferior PV (OR 0.36; 95% CI 0.13-0.99; P = .047) as well as the presence of a right middle PV for the right superior PV (OR 3.58; 95% CI 1.18-10.9; P = .024). The absence of an orthogonal orientation of the left superior PV was associated with atrial tachyarrhythmia recurrence (OR 4.12; 95% CI 1.90-9.11; P < .001).
CONCLUSION: The absence of an orthogonal orientation of the left-sided PVs was significantly associated with lower first-pass isolation rates and a higher risk of recurrence. These findings highlight the importance of preprocedural anatomical assessment to identify potential challenges and tailor ablation strategies.