ArticleHeart rhythm O22024
Identification of epicardial connections can improve the success rate of first-pass right pulmonary vein isolation.
Article in Heart rhythm O2, 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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Who cites it
2 citing papers in PubMed.
- High-amplitude pacing can identify epicardial connections in the posterior wall during ablation for atrial fibrillation.Heart rhythm O2 · 2025Article
- Post-pulmonary vein isolation voltage remapping-guided incremental lesions: A feasible strategy to improve long-term outcomes.Heart rhythm O2 · 2025Article
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Authors and funding
11 authors.
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Abstract
Background: Epicardial connections between the right pulmonary vein (PV) and the right atrium have been reported. Objective: The purpose of this study was to evaluate the usefulness of our new pulmonary vein isolation (PVI) strategy with identification of these epicardial connections. Methods: Overall, 235 patients with atrial fibrillation were included. High-density mapping of the left atrium was performed to identify the earliest activation sites (EASs) before PVI in all patients. With our new strategy, if EASs around the right PV carina were identified, we ablated these sites and performed usual first-pass circumferential PVI. The patients were divided into 2 groups according to the ablation strategy. One hundred fifteen patients underwent first-pass PVI without information on EASs (nonanalyzed group), and 78 patients underwent ablation at EASs around the right PV carina in addition to PVI (analyzed group). After first-pass ablation around the PV antrum, remapping was performed. Results: High-density mapping before PVI showed that the prevalence of EASs around the right PV carina was 10.9% in all patients (9.6% in the nonanalyzed group, 12.8% in the analyzed group; Conclusion: Identification of epicardial connections before ablation could improve the success rate of first-pass right PVI.
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