ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2017
High-voltage zones within the pulmonary vein antra: Major determinants of acute pulmonary vein reconnections after atrial fibrillation ablation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 26 citations in OpenAlex.
- Contact Index-Guided Pulsed Field Ablation: A Two-Phase Validation of the Impedance Change Threshold to Prevent Acute Pulmonary Vein Gaps.Journal of arrhythmia · 2026Article
- Atrial fibrillation substrate mapping with emphasis on voltage-based guidance.World journal of cardiology · 2025Review
- Wall Thickness-Guided vs. Voltage-Guided Pulmonary Vein Isolation for Atrial Fibrillation.Journal of arrhythmia · 2025Article
- Where is the gap after a 90 W/4 s very-high-power short-duration ablation of atrial fibrillation?: Association with the left atrial-pulmonary vein voltage and wall thickness.Journal of arrhythmia · 2024Article
- Unipolar-voltage-based evaluation of left atrial tissue properties and ablation outcome in patients with atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Impact of tag index and local electrogram for successful first-pass cavotricuspid isthmus ablation.Heart rhythm O2 · 2023Article
- In vivo tissue temperatures during 90 W/4 sec-very high power-short-duration (vHPSD) ablation versus ablation index-guided 50 W-HPSD ablation: A porcine study.Journal of cardiovascular electrophysiology · 2023Article
- Modified ablation index: a novel determinant of a successful first-pass left atrial posterior wall isolation.Heart and vessels · 2022Article
- Effectiveness of the Early Staged Hybrid Approach for Treatment of Symptomatic Atrial Fibrillation: the Electrophysiology Study Could Be Deferred?Journal of Korean medical science · 2021Article
- Optimized lesion size index (o-LSI): A novel predictor for sufficient ablation of pulmonary vein isolation.Journal of arrhythmia · 2021Article
- The modified ablation index: a novel determinant of acute pulmonary vein reconnections after pulmonary vein isolation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2019Article
- Influence of balloon temperature and time to pulmonary vein isolation on acute pulmonary vein reconnection and clinical outcomes after cryoballoon ablation of atrial fibrillation.Journal of arrhythmia · 2018Article
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRecurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) is mainly due to PV reconnections. Patient-specific tissue characteristics that may contribute remain unidentified. This study aimed to assess the relationship between the bipolar electrogram voltage amplitudes recorded from the PV-left atrial (LA) junction and acute PV reconnection sites.
methodsThree-dimensional LA voltage maps created before an extensive encircling PVI in 47 AF patients (31 men; mean age 62 ± 11 years) were examined for an association between the EGM voltage amplitude recorded from the PV-LA junction and acute post-PVI PV reconnections (spontaneous PV reconnections and/or ATP-provoked dormant PV conduction).
resultsAcute PV reconnections were observed in 17 patients (36%) and in 24 (3%) of the 748 PV segments (16 segments per patient) and were associated with relatively high bipolar voltage amplitudes (3.26 ± 0.85 vs. 1.79 ± 1.15 mV, p < 0.0001) and a relatively low mean force-time integral (FTI) (428 ± 56 vs. 473 ± 76 gs, p = 0.0039) as well as FTI/PV-LA bipolar voltage (137 [106, 166] vs. 295 [193, 498] gs/mV, p < 0.0001). An analysis of the receiver operating characteristic curves revealed a high prognostic performance of the LA bipolar voltage and FTI/PV-LA bipolar voltage for acute PV reconnections (areas under the curve: 0.86 and 0.89, respectively); the best cutoff values were >2.12 mV and ≤183 gs/mV, respectively.
conclusionsThe PV-LA voltage on the PV-encircling ablation line and FTI/PV-LA voltage were related to the acute post-PVI PV reconnections. A more durable ablation strategy is warranted for high-voltage zones.
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