Impact of variant pulmonary vein anatomy and image integration on long-term outcome after catheter ablation for atrial fibrillation

• DOI: 10.1093/europace/euq322
• Publication Date: 2010-09-07T20:19:38Z
• Authors: R. J. Hunter; M. Ginks; R. Ang; I. Diab; F. C. Goromonzi; S. Page; V. Baker; L. Richmond; M. Tayebjee; S. Sporton; M. J. Earley; R. J. Schilling
• Keywords: Atrial tachycardia

To investigate the impact of variant pulmonary vein (PV) anatomy and use three-dimensional image integration (3D-II) on long-term efficacy catheter ablation for atrial fibrillation (AF). Consecutive procedures from 2002 to 2007 were analysed a prospective database. All patients underwent wide area circumferential ablation, with linear lesions added complex fractionated electrograms targeted persistent AF. Imaging was segmented Carto assess PV anatomy. Three hundred fifty 1.9 ± 0.9 procedures. The mean age 57 11 years, 73% males, 55% paroxysmal Freedom AF/atrial tachycardia 42% AF 20% at 3.1 years after first procedure, or 86 66%, respectively, 2.5 last procedure. Kaplan–Meier analysis showed trend towards improved single-procedure 3D-II (8.9% difference, P = 0.087) reduction in number per patient 2.1 1.1 1.8 (P < 0.0001). (13.3% 0.018), but not Ensite NavX. Variant identified 28% associated lower (10.0% 0.024) no effect final outcome. Multivariate confirmed [hazard ratio (HR) recurrence 0.67, 0.020] (HR 1.37, 0.044). improves isolation success rate.