Arrhythmias & electrophysiology
Predictors of late pulmonary vein reconnection in patients with arrhythmia recurrence after cryoballoon ablation—per vein analysis including cardiac computed tomography–based anatomic factors
Authors' conclusion
Cardiac CT-based evaluation of anatomic PV characteristics presented higher predictive value compared to clinical and procedural variables for individual LPVR after CB2 ablation.
Study context
- Population
- Patients with repeat procedure for arrhythmia recurrence after index second-generation cryoballoon (CB2) ablation486 pulmonary vein (PVs) on computed tomography (CT)
- Participants
- 125 patients
- Outcome
- Predictors of individual late PV reconnection (late pulmonary vein reconnection (LPVR))
Methodological detailsper-vein analysis, multivariable analysis
- Per-vein analysis
- Multivariable analysis
Main finding
As reported in the abstract
Independent predictors of LPVR per vein (multivariable)
Odds ratio (95% CI)P value
Ovality index (LSPV)
1.61(1.07–2.41)
P = 0.022Carina width (LSPV)
0.75(0.59–0.96)
P = 0.024Carina width (LIPV)
0.71(0.53–0.95)
P = 0.020Frontal angle (RIPV)
0.91(0.87–0.95)
P < 0.001Transversal angle (RSPV)
1.15(1.03–1.31)
P = 0.032Per vein, as printed
Observational data: associations, not effects.
Further findings
Durable isolation in all PVs
- Patients with durable isolation of all PVs
- 50/125 (40%)
Late reconnection rate by PV
- LSPV
- 16%
- LIPV
- 12%
- RSPV
- 17%
- RIPV
- 31%
Original publication
Predictors of late pulmonary vein reconnection in patients with arrhythmia recurrence after cryoballoon ablation—per vein analysis including cardiac computed tomography–based anatomic factors. Eur Heart J Cardiovasc Imaging. Published 23 December 2022. doi:10.
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