ArticleHeart rhythm O22026
Pulmonary vein to ganglionated plexi distance predicts cryoballoon ganglionated plexi modification.
Article in Heart rhythm O2, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Background: Cryoballoon ablation (CBA) for atrial fibrillation (AF) can cause incidental modification of ganglionated plexi (GP), which may contribute to arrhythmia control; however, the anatomic factors associated with GP modification remain poorly understood. Objective: We investigated the relationship between the distance from the pulmonary vein-left atrial (PV-LA) junction to GP sites and GP modification during CBA using voltage mapping. Methods: This retrospective study analyzed 50 patients with paroxysmal AF undergoing CBA. Preprocedural computed tomography images were integrated into a 3-dimensional electroanatomic mapping system to measure PV-LA junction to GP (PV-GP) distances. GP modification was defined as voltage attenuation at GP sites after ablation. Receiver operating characteristic analysis was performed to assess predictive performance. Results: GP modification occurred more frequently at sites located closer to the PV-LA junction. Upper GP regions demonstrated higher modification rates than lower regions, and PV-GP distance showed reasonable discrimination for predicting GP modification. Conclusion: Anatomic proximity between the PV-LA junction and GP seems to be a key determinant of GP modification during CBA. Quantitative assessment of PV-GP distance may help predict autonomic effects and support optimization of AF ablation strategies.
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