Predictors of durable electrical isolation in the setting of second‐generation cryoballoon ablation: A comparison between left superior, left inferior, right superior, and right inferior pulmonary veins

• DOI: 10.1111/jce.14286
• Publication Date: 2019-11-21T04:28:54Z
• Authors: Oriana Scala; Gianluca Borio; Gaetano Paparella; Varnavas Varnavas; Erwin Ströker; Thiago Guimaraes ...; Muryo Terasawa; Juan Sieira; Riccardo Maj; Alessandro Rizzo; Maysam M. Al‐Hosari; Alessio Galli; Pedro Brugada; Carlo de Asmundis; Gian‐Battista Chi...
• Keywords: Left Pulmonary Vein

The aim of this study is to assess specific per-vein procedural predictors pulmonary vein (PV) late reconnection in cryoballoon ablation (CbA) METHODS AND RESULTS: We enrolled 148 consecutive patients undergoing a redo procedure after previous index CbA our center. A at least one PV was found 80 (54.1%) and the most frequently reconnected right inferior (RIPV). Overall, (PVr) associated with longer time -40°C (Tt-40°C) (54.4 ± 21.7 vs 67.6 27.6 seconds; P < .001), warmer nadir temperature (NT) (-49.7°C 5.4°C -46.5°C 5.8°C; .001) 60 seconds (-41.8°C 4.5°C -39.8°C 4.2°C; .001). performance these differed between veins. In particular, comparable behavior observed for left superior (LSPV) (RSPV), where NT ≤ -48°C showed sensibility specificity, respectively, 62% 65% 71% 72% predicting durable isolation. For RIPV, sensitivity 74% but low specificity (53%). Tt less than good negative predictive values, 83.9% LSPV, 94.9% (LIPV), 90.2% RSPV, 82.7% RIPV. Previous cannot be used LIPV.Freezing rates differ significantly among four PVs. Freezing parameters strongly predict PVr PVs are slightly different RIPV can applied as well. LIPV freezing different. Its uncommon even subset worse temperatures CB identified.