Evidence map›Paper›PMID 38700611›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Impact of inter-lesion distance and first-pass isolation on outcomes of pulmonary venous isolation for paroxysmal atrial fibrillation.

Dan Bo, Dongsheng Zhao, Yan Dong, Wei Zhao, Qiushi Chen, Nishant Yadav, Pipin Kojodjojo, Fengxiang Zhang

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Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Dan Bo *Electrophysiology and Pacing Unit, Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
Dongsheng Zhao *Electrophysiology and Pacing Unit, Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
Yan Dong *Electrophysiology and Pacing Unit, Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
Wei ZhaoElectrophysiology and Pacing Unit, Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
Qiushi Chen *Electrophysiology and Pacing Unit, Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
Nishant Yadav *Electrophysiology and Pacing Unit, Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China.
Pipin KojodjojoNational University of Singapore, Asian Heart and Vascular Centre, Singapore, Singapore.
Fengxiang ZhangElectrophysiology and Pacing Unit, Department of Cardiology, The First Affiliated Hospital With Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, China. njzfx6@njmu.edu.cn.

Funding

Project 333 of Jiangsu Province 2022-2-408
6 · The paper itself

Abstract

backgroundContiguity of ablation lesions is a critical determinant of success for paroxysmal atrial fibrillation (PAF) ablation. Evidence supports maintaining an inter-lesional distance (ILD) ≤ 6 mm during pulmonary venous isolation (PVI). Meanwhile, first-pass isolation (FPI) on PVI outcome in follow-up was not deeply studied. The impact of ILD and FPI on PAF ablation outcomes was investigated.

methodsConsecutive PAF patients who underwent first-time antral PVI were recruited. Coordinates of ablation points were extracted from the electro-anatomical mapping system and analyzed using custom-developed software to determine the ILD. A gap is defined as ILD greater than 6 mm. FPI was defined as the achievement of PVI by encircling the ipsilateral veins while simultaneously recording their electrical activity using a multipolar catheter. The primary endpoint was freedom from documented atrial arrhythmias including AF, atrial tachycardia (AT), or atrial flutter (AFL) lasting longer than 30 s during follow-up.

resultsA total of 105 patients underwent first-time antral PVI. During 13.3 ± 0.6 months of follow-up, atrial arrhythmias recurrence was noted in 22.9% of the patients. Atrial arrhythmia recurrence was significantly higher in patients with more gaps (> 2) (37.0% versus 11.9%, P < 0.01), and the number of gaps was an independent predictor of AF/AT/AFL recurrence. (Hazard ratio [HR] 1.20, 95% CI 1.03-1.40, P = 0.02). The group with FPI for at least one ipsilateral pair of PVs exhibited a decreased number of gaps (2.0 versus 7.0, P < 0.01) and demonstrated a significant correlation with a reduction of recurrence (HR 0.26, 95% CI 0.09-0.71, P = 0.01). Among 16 patients who underwent repeat ablation, the number of gaps during the index PVI was associated with PV reconnection (PVR) (P < 0.01).

conclusionsGaps created during PVI are a modifiable determinant of AF/AT/AFL recurrence, and avoidance of gaps is crucial to improve clinical outcomes of PAF ablation. In addition, FPI exhibited a strong predictive capability for clinical success in patients with PAF.

Indexed as

Atrial FibrillationCatheter AblationPulmonary VeinsFemaleHumansMaleMiddle AgedRecurrenceRetrospective StudiesTreatment OutcomeArrhythmia recurrenceFirst-pass isolationInter-lesional distanceParoxysmal atrial fibrillationPulmonary vein isolationReconnection

Identifiers

PMID38700611

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.