ArticleOpen heart2024
Empirical superior vena cava electrical isolation guided by quantitative ablation index improves outcomes of radiofrequency catheter ablation for paroxysmal atrial fibrillation.
Article in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- The impact of empirical superior vena cava isolation in addition to pulmonary vein isolation on outcomes in atrial fibrillation - Systematic review, meta-analysis, and meta-regression.International journal of cardiology. Heart & vasculature · 2025Article
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4 authors.
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Abstract
backgroundThe value of empirical superior vena cava isolation (SVCI) following pulmonary vein isolation (PVI) to improve the efficacy of radiofrequency catheter ablation (RFCA) for paroxysmal atrial fibrillation (PAF) remains controversial.
objectiveTo evaluate the efficacy and safety of quantitative ablation index (AI)-guided empirical SVCI, in addition to PVI, for patients with PAF.
methodsPatients with symptomatic PAF who underwent RFCA between October 2021 and May 2023 were retrospectively analysed. Patients were categorised into PVI-only group and PVI+SVCI group based on the intraoperative ablation strategy. RFCA was guided by quantitative AI in both groups. Regular clinical follow-ups were conducted to detect AF recurrence, defined as any episode of atrial fibrillation, atrial flutter or atrial tachycardia lasting >30 s.
resultsA total of 246 patients were enrolled, with 108 patients in the PVI group and 138 patients in the PVI+SVCI group. Compared with the PVI group, patients in the PVI+SVCI group had a higher prevalence of coronary artery disease (p=0.04), stroke (p=0.02) and a smaller left atrial diameter (p<0.01). After a follow-up period of 16±6 months, the ablation success rate was significantly higher in the SVCI+PVI group compared with the PVI group (91.3% vs 81.5%, p=0.02). Multivariable logistic regression analysis indicated that SVCI was an independent predictor of reduced AF recurrence postablation (Relative Risk [RR] 0.4, 95% CI 0.19 to 0.90, p=0.026). No significant difference in complication rates was observed between the groups.
conclusionQuantitative AI-guided empirical SVCI, in addition to PVI, improves the success rate of RFCA for PAF without increasing the risk of complications.
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