Zsofia Nagy1, Zsuzsanna Kis1, Zoltan Som1, Krisztian Kassa2, Levente Csakany1, Tamas Major1, Csaba Foldesi1, Attila Kardos1
1 Gottsegen Gyorgy Hungarian Institute of Cardiology, Budapest, Electrophysiology Department
2 Semmelweis University, Budapest
Introduction: Late pulmonary vein reconnection (PVR) determines recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) procedures. The PVR rate was reported to be lower following the second-generation cryoballoon (CB) as compared to contact-force sensing radiofrequency (CF-RF) ablation using circular mapping catheters. Aims: In this single-center, retrospective study, the incidence and pattern of late PVR following an index PVI using the CB versus CF-RF catheter were examined with multielectrode mapping catheters (PentaRay). Method: A total of 66 [31 (47%) women, mean age=63±11.6 years] pts underwent a redo ablation due to AF recurrence after an index PVI accomplished with CB (n=37 pts) or CF-RF (n=29 pts). All repeated procedures were achieved in sinus rhythm using bipolar voltage map with multielectrode mapping catheter and the CARTO 3 Confidense Module (mean number of points=1012±602). We examined the reconnection pattern of the antral lesion sets. Results: Among 109 PVs in the CF-RF group, 82 (75.2%) showed conduction gaps in 28 pts (2.9 per patient). Whereas among 143 PVs in the CB group, 107 (74.8%) showed a PVR in 37 pts (2.9 per patient) (p=0.81). After CF-RF ablation, the inferior and the posterior part of the right inferior PV and the right carina showed conduction gaps more likely. In the CB group, the left atrial appendage-left superior PV ridge and the superior segment of the left superior PV were most frequently reconnected. In the CB group late PVR was associated with higher nadir temperature (-52.8±5.3°C vs -42.2±8.6°C, p=0.031), while in the CF-RF group the mean CF was lower in the reconnected PVs as compared to those PVs which remained isolated (10±3.2 g vs 18.8±4.9 g, p<0.05). Conclusion: In our single-center analysis no difference was observed in the PVR incidence and the antral lesion sets after CB or CF-RF ablation.
EFOP "Kiegészítő Kiválósági Kutatási Ösztöndíj"
Supervisor: Attila Kardos MD PhD