The Extent of Pulmonary Vein Electrical Connections Predicts the Success of Stand‐Alone Pulmonary Vein Isolation in Persistent Atrial Fibrillation

• DOI: 10.1111/jce.16622
• Publication Date: 2025-03-12T04:55:17Z
• Authors: Matteo Marchetti; Christelle Haddad; Adrian Luca; Mathieu Le Bloa; Cheryl Teres; Giulia Domenichini; Alessandra Pia Po...; Claudia Herrera; Etienne Pruvot; Patrizio Pascale

Identification of persistent AF (PsAF) patients who may be cured with stand-alone pulmonary vein isolation (PVI) would allow more efficient ablation strategies. Intuitively, the benefit PVI is expected to lower when PVs are poorly connected, but this assumption has never been tested. Evaluate whether circumferential extent PV connections assessed pre-ablation predicts success rate PVI. Consecutive PsAF undergoing first were included. The electrical connection was using a circular mapping catheter and graded as limited, moderate, or extensive, according tertiles mean numbers bipoles recording potentials along circumference each vein. One hundred forty-eight included (age 64 ± 9.7 years, duration 7.3 7 months). After follow-up 38.6 7.8 months, freedom from arrhythmia recurrence after last significantly in limited (38.6%), compared extensive (69.7% 69%, respectively; p = 0.002). While redo procedures did not affect final outcomes connections, significant incremental arrhythmia-free survival gain observed increasing (p < 0.01). correlated marker contribution AF. finding used select first-line adjunctive ablation.