ArticleJournal of cardiovascular electrophysiology2025
The Extent of Pulmonary Vein Electrical Connections Predicts the Success of Stand-Alone Pulmonary Vein Isolation in Persistent Atrial Fibrillation.
Article in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- The extent of pulmonary vein electrical connection and sex are independent predictors of the mechanistic role of pulmonary veins in persistent atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Catheter ablation of atrial fibrillation: time to look beyond iterative pulmonary vein isolation only and "one-size-fits-all" strategies.Indian pacing and electrophysiology journalReview
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundIdentification 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 of PVI is expected to be lower when PVs are poorly connected, but this assumption has never been tested.
objectiveEvaluate whether the circumferential extent of PV connections assessed pre-ablation predicts the success rate of PVI.
methodsConsecutive patients with PsAF undergoing first ablation with stand-alone PVI were included. The extent of PV electrical connection was assessed using a circular mapping catheter and graded as limited, moderate, or extensive, according to tertiles of the mean numbers of bipoles recording PV potentials along the circumference of each vein.
resultsOne hundred and forty-eight patients were included (age 64 ± 9.7 years, PsAF duration 7.3 ± 7 months). After a mean follow-up of 38.6 ± 7.8 months, freedom from arrhythmia recurrence after last PVI was significantly lower in patients with limited (38.6%), compared to moderate, and extensive PV connections (69.7% and 69%, respectively; p = 0.002). While redo PVI procedures did not significantly affect final ablation outcomes in patients with limited PV connections, a significant incremental arrhythmia-free survival gain was observed with increasing extent of PV connections (p < 0.01).
conclusionsThe circumferential extent of PV connections is correlated to the success rate of PVI in patients with PsAF and may be a marker of the contribution of PVs to AF. The finding of limited PV connections may be used to select patients who may benefit from first-line adjunctive ablation.
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