Arrhythmias & electrophysiology
Evaluation of Intercaval Bundle Connection by Multisite Pacing and Right-Sided Pulmonary Vein Isolation
Authors' conclusion
The IBC was visualized in all cases by multisite pacing. An attachment site on the LA side influenced the frequency of additional ablation for the right anterior PV carina.
Study context
- Population
- Patients undergoing first pulmonary vein (PV) isolation under radiofrequency ablation
- Participants
- 108 patients
- Exposure
- Multisite pacing vs right atrium (RA) pacing for delineating intercaval bundle connection (IBC)
- Outcome
- Frequency and distribution of IBC diagnosed by multisite pacing and its relation to PV isolation outcomes
Main finding
As reported in the abstract
IBC delineated
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Median distance from EAS-LA to PV ostium, by EAS-RA position | Above median 3.4 (IQR −2.1–7.2) mm · Below median 7.7 (IQR 6.8–13.5) mm · Far below median 15.2 (IQR 13.4–20.7) mm |
| Additional ablation for the anterior carina, by EAS-LA position | PV inside 75.0% · PV side 46.7% · LA side 6.2% |
- Median distance from earliest activation site of the left atrium (EAS-LA) to PV ostium, by earliest activation site of RA (EAS-RA) position: P < 0.001
- Median distance from EAS-LA to PV ostium, by EAS-RA position: EAS-RA: above n = 19, below n = 79, far below n = 10
- Additional ablation for the anterior carina, by EAS-LA position: P < 0.001
- Additional ablation for the anterior carina, by EAS-LA position: EAS-LA: PV inside n = 11, PV side n = 15, LA side n = 81
EAS-RA position and EAS-LA position
- "Above" EAS-RA was related to "PV inside" EAS-LA
Original publication
Evaluation of Intercaval Bundle Connection by Multisite Pacing and Right-Sided Pulmonary Vein Isolation. JACC Adv. Published 29 December 2025. doi:10.
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