ArticleHeart rhythm O22025
Impact of fat on the left atrial roof identified using intracardiac echocardiography during pulmonary vein isolation procedures.
Article in Heart rhythm O2, 2025. 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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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.
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Who cites it
1 citing paper in PubMed.
- Epicardial muscle bundles in persistent atrial fibrillation: from overlooked bystanders to arrhythmogenic modulators.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Previous studies have reported the presence of fat between the septopulmonary bundle and the septoatrial bundle on the left atrial (LA) roof. This fat may increase the wall thickness and protect the septopulmonary bundle from radiofrequency energy, potentially leading to conduction gaps. Objective: This study aimed to determine whether fat on the LA roof can be identified using intracardiac echocardiography (ICE) and whether its presence affects the procedural outcomes of pulmonary vein isolation (PVI). Methods: We evaluated 94 patients undergoing first-time radiofrequency catheter ablation for atrial fibrillation (60 men [63.8%]; mean age 65.7±10.7 years; 46 with paroxysmal atrial fibrillation [48.9%]) between February 2021 and September 2023. ICE was used to visualize the LA roof, and hypoechoic regions suggestive of fat were marked within the CARTOSOUND map (Biosense Webster, Irvine, CA). PVI was then performed with a personalized isolation line, avoiding fat regions when feasible. Results: Fat on the LA roof was identified in 35 of 94 patients (37.2%). Conduction gaps on the left pulmonary vein roof were observed in 7 of 35 patients with fat (20.0%) and 1 of 59 patients without fat (1.7%) ( Conclusion: The findings indicate that the presence of fat on the LA roof, as identified using ICE, may be associated with a higher incidence of conduction gaps after PVI.
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