Cryoballoon ablation of atrial fibrillation in patients with atypical right pulmonary vein anatomy - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Archives of cardiovascular diseases Année : 2020

Cryoballoon ablation of atrial fibrillation in patients with atypical right pulmonary vein anatomy

Résumé

Background - Cryoballoon ablation is widely used for pulmonary vein isolation in patients with atrial fibrillation. There are no data regarding the clinical efficacy of cryoballoon ablation in patients with atypical right pulmonary vein anatomy. Aim - We aimed to evaluate the impact of right pulmonary vein anatomy on the safety and efficacy of cryoballoon ablation. Methods - Patients referred for cryoballoon ablation of paroxysmal atrial fibrillation were enrolled prospectively. Left atrial computed tomography was performed before cryoballoon ablation to determine whether the right pulmonary vein anatomy was "normal" or "atypical". For patients with atypical anatomy, cryoballoon ablation was only performed for right superior and right inferior pulmonary veins, neglecting accessory pulmonary veins. Results - Overall, 303 patients were included: 254 (83.8%) with normal and 49 (16.2%) with atypical right pulmonary vein anatomy. First-freeze isolation for right superior and right inferior pulmonary veins occurred in 44 (89.8%) and 37 (75.5%) patients with atypical pulmonary vein anatomy, and in 218 (85.8%) and 217 (85.4%) patients with typical pulmonary vein anatomy, respectively (P not significant). Phrenic nerve palsies were only observed in patients with normal anatomy (0 vs. 26 [8.6%]; P=0.039). Mid-term survival free from atrial arrhythmia was similar, regardless of right pulmonary vein anatomy. Conclusions - A significant proportion of patients have atypical right pulmonary vein anatomy. Procedural characteristics, acute pulmonary vein isolation success and mid-term procedural efficacy were similar, regardless of right pulmonary vein anatomy. In addition to left-side pulmonary vein isolation, cryoballoon ablation of right superior and right inferior pulmonary veins only, neglecting accessory pulmonary veins, is sufficient to obtain acute right-side pulmonary vein isolation and mid-term sinus rhythm maintenance in patients with atypical anatomy.
Fichier principal
Vignette du fichier
S1875213620301601.pdf (1.04 Mo) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-02958981 , version 1 (15-12-2022)

Licence

Paternité - Pas d'utilisation commerciale

Identifiants

Citer

Camille Pichard, Amélie Nicolas, Vincent Galand, C Coquard, Nathalie Behar, et al.. Cryoballoon ablation of atrial fibrillation in patients with atypical right pulmonary vein anatomy. Archives of cardiovascular diseases, 2020, 113 (11), pp.690-700. ⟨10.1016/j.acvd.2020.05.008⟩. ⟨hal-02958981⟩
42 Consultations
11 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More