Disappearance pattern and the last remaining earliest pulmonary vein potential during cryoballoon ablation in predicting recurrence and conduction gap site of pulmonary veins
Electrophysiological studies have rarely evaluated the sites prone to pulmonary vein (PV) conduction gap during cryoballoon ablation (CBA) for atrial fibrillation (AF). In addition, no studies have analyzed the sequence of PV potentials just before PV isolation during CBA for AF. Of the 238 patients...
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| Veröffentlicht in: | Heart and vessels 2021-08, Vol.36 (8), p.1190-1200 |
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| creator | Mizutani, Yoshiaki Inden, Yasuya Yanagisawa, Satoshi Kanashiro, Masaaki Makino, Yuichiro Satake, Akinori Kurobe, Masanari Ichimiya, Hitoshi Uchida, Yasuhiro Watanabe, Junji Ichimiya, Satoshi Murohara, Toyoaki |
| description | Electrophysiological studies have rarely evaluated the sites prone to pulmonary vein (PV) conduction gap during cryoballoon ablation (CBA) for atrial fibrillation (AF). In addition, no studies have analyzed the sequence of PV potentials just before PV isolation during CBA for AF. Of the 238 patients who underwent first-time CBA for paroxysmal AF, 115 PVs of 29 patients who underwent repeat session due to recurrence after the procedure were retrospectively evaluated in the study. We evaluated the disappearance pattern of PV potential and PV reconnection on intracardiac electrograms and investigated whether the conduction gap site of the PV was related to the last remaining earliest PV potential (EP) and sequence pattern during the first-time CBA. Time to isolation was observed in 81 PVs during the first-time CBA. At the repeat session, PV reconnection was only observed in 22 of 81 PVs. PV potentials disappeared with sequence changes in 36 PVs and without sequence changes in 38 PVs. Multivariate analysis demonstrated that disappearance of PV potentials without change in the EP site but with delay or disappearance of other PV potentials was independently associated with PV reconnection (12/22 PVs [55%] vs. 4/59 PVs [6.8%]; odds ratio 14.4; 95% confidence interval 3.75–55.5;
p
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| doi_str_mv | 10.1007/s00380-021-01785-3 |
| format | Article |
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p
< 0.001). In 19 of 22 (86%) reconnected PVs, PV conduction gap sites at repeat ablation corresponded with the last remaining EP sites during first-time CBA. In conclusion, disappearance pattern of the PV potential and the last remaining EP during the CBA can predict PV reconnection and gap site.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-021-01785-3</identifier><identifier>PMID: 33496818</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Ablation ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Conduction ; Confidence intervals ; Fibrillation ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Original Article ; Vascular Surgery</subject><ispartof>Heart and vessels, 2021-08, Vol.36 (8), p.1190-1200</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-8515d2e274d96a693156d4f5f232d958fb913b2d739c9a4bbe0e4f88c90ee2ce3</citedby><cites>FETCH-LOGICAL-c454t-8515d2e274d96a693156d4f5f232d958fb913b2d739c9a4bbe0e4f88c90ee2ce3</cites><orcidid>0000-0003-2373-7059</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-021-01785-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-021-01785-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33496818$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mizutani, Yoshiaki</creatorcontrib><creatorcontrib>Inden, Yasuya</creatorcontrib><creatorcontrib>Yanagisawa, Satoshi</creatorcontrib><creatorcontrib>Kanashiro, Masaaki</creatorcontrib><creatorcontrib>Makino, Yuichiro</creatorcontrib><creatorcontrib>Satake, Akinori</creatorcontrib><creatorcontrib>Kurobe, Masanari</creatorcontrib><creatorcontrib>Ichimiya, Hitoshi</creatorcontrib><creatorcontrib>Uchida, Yasuhiro</creatorcontrib><creatorcontrib>Watanabe, Junji</creatorcontrib><creatorcontrib>Ichimiya, Satoshi</creatorcontrib><creatorcontrib>Murohara, Toyoaki</creatorcontrib><title>Disappearance pattern and the last remaining earliest pulmonary vein potential during cryoballoon ablation in predicting recurrence and conduction gap site of pulmonary veins</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Electrophysiological studies have rarely evaluated the sites prone to pulmonary vein (PV) conduction gap during cryoballoon ablation (CBA) for atrial fibrillation (AF). In addition, no studies have analyzed the sequence of PV potentials just before PV isolation during CBA for AF. Of the 238 patients who underwent first-time CBA for paroxysmal AF, 115 PVs of 29 patients who underwent repeat session due to recurrence after the procedure were retrospectively evaluated in the study. We evaluated the disappearance pattern of PV potential and PV reconnection on intracardiac electrograms and investigated whether the conduction gap site of the PV was related to the last remaining earliest PV potential (EP) and sequence pattern during the first-time CBA. Time to isolation was observed in 81 PVs during the first-time CBA. At the repeat session, PV reconnection was only observed in 22 of 81 PVs. PV potentials disappeared with sequence changes in 36 PVs and without sequence changes in 38 PVs. Multivariate analysis demonstrated that disappearance of PV potentials without change in the EP site but with delay or disappearance of other PV potentials was independently associated with PV reconnection (12/22 PVs [55%] vs. 4/59 PVs [6.8%]; odds ratio 14.4; 95% confidence interval 3.75–55.5;
p
< 0.001). In 19 of 22 (86%) reconnected PVs, PV conduction gap sites at repeat ablation corresponded with the last remaining EP sites during first-time CBA. In conclusion, disappearance pattern of the PV potential and the last remaining EP during the CBA can predict PV reconnection and gap site.</description><subject>Ablation</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Conduction</subject><subject>Confidence intervals</subject><subject>Fibrillation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Original Article</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc2KFTEQhYMoznX0BVxIwI2b1vx2J0sZf2HAja5DOqkeM-QmbZIW5qV8RtNzR4VZuKpQfHVOVQ5Czyl5TQmZ3lRCuCIDYXQgdFJy4A_QgY5UDkxO_CE6EE3JoDibztCTWq8JoVJT_RidcS70qKg6oF_vQrXrCrbY5ACvtjUoCdvkcfsOONracIGjDSmkK9yxGKC31i0ec7LlBv-EkPCaG6QWbMR-Kzvoyk2ebYw5d6052hb6YwcL-ODajhRwWymwu-5uLie_uVvuyq64hgY4L_eM6lP0aLGxwrO7eo6-fXj_9eLTcPnl4-eLt5eDE1K0QUkqPQM2Ca9HO2pO5ejFIhfGmddSLbOmfGZ-4tppK-YZCIhFKacJAHPAz9Grk-5a8o-tX2yOoTqI0SbIWzVMKEoZl0p29OU99DpvJfXtDJNCaU6EVJ1iJ8qVXGuBxawlHPtdhhKzp2lOaZqeprlN0_A-9OJOepuP4P-O_ImvA_wE1HX_dij_vP8j-xsZ5q8Y</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Mizutani, Yoshiaki</creator><creator>Inden, Yasuya</creator><creator>Yanagisawa, Satoshi</creator><creator>Kanashiro, Masaaki</creator><creator>Makino, Yuichiro</creator><creator>Satake, Akinori</creator><creator>Kurobe, Masanari</creator><creator>Ichimiya, Hitoshi</creator><creator>Uchida, Yasuhiro</creator><creator>Watanabe, Junji</creator><creator>Ichimiya, Satoshi</creator><creator>Murohara, Toyoaki</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2373-7059</orcidid></search><sort><creationdate>20210801</creationdate><title>Disappearance pattern and the last remaining earliest pulmonary vein potential during cryoballoon ablation in predicting recurrence and conduction gap site of pulmonary veins</title><author>Mizutani, Yoshiaki ; Inden, Yasuya ; Yanagisawa, Satoshi ; Kanashiro, Masaaki ; Makino, Yuichiro ; Satake, Akinori ; Kurobe, Masanari ; Ichimiya, Hitoshi ; Uchida, Yasuhiro ; Watanabe, Junji ; Ichimiya, Satoshi ; Murohara, Toyoaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-8515d2e274d96a693156d4f5f232d958fb913b2d739c9a4bbe0e4f88c90ee2ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Ablation</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Conduction</topic><topic>Confidence intervals</topic><topic>Fibrillation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Original Article</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mizutani, Yoshiaki</creatorcontrib><creatorcontrib>Inden, Yasuya</creatorcontrib><creatorcontrib>Yanagisawa, Satoshi</creatorcontrib><creatorcontrib>Kanashiro, Masaaki</creatorcontrib><creatorcontrib>Makino, Yuichiro</creatorcontrib><creatorcontrib>Satake, Akinori</creatorcontrib><creatorcontrib>Kurobe, Masanari</creatorcontrib><creatorcontrib>Ichimiya, Hitoshi</creatorcontrib><creatorcontrib>Uchida, Yasuhiro</creatorcontrib><creatorcontrib>Watanabe, Junji</creatorcontrib><creatorcontrib>Ichimiya, Satoshi</creatorcontrib><creatorcontrib>Murohara, Toyoaki</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mizutani, Yoshiaki</au><au>Inden, Yasuya</au><au>Yanagisawa, Satoshi</au><au>Kanashiro, Masaaki</au><au>Makino, Yuichiro</au><au>Satake, Akinori</au><au>Kurobe, Masanari</au><au>Ichimiya, Hitoshi</au><au>Uchida, Yasuhiro</au><au>Watanabe, Junji</au><au>Ichimiya, Satoshi</au><au>Murohara, Toyoaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disappearance pattern and the last remaining earliest pulmonary vein potential during cryoballoon ablation in predicting recurrence and conduction gap site of pulmonary veins</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>36</volume><issue>8</issue><spage>1190</spage><epage>1200</epage><pages>1190-1200</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>Electrophysiological studies have rarely evaluated the sites prone to pulmonary vein (PV) conduction gap during cryoballoon ablation (CBA) for atrial fibrillation (AF). In addition, no studies have analyzed the sequence of PV potentials just before PV isolation during CBA for AF. Of the 238 patients who underwent first-time CBA for paroxysmal AF, 115 PVs of 29 patients who underwent repeat session due to recurrence after the procedure were retrospectively evaluated in the study. We evaluated the disappearance pattern of PV potential and PV reconnection on intracardiac electrograms and investigated whether the conduction gap site of the PV was related to the last remaining earliest PV potential (EP) and sequence pattern during the first-time CBA. Time to isolation was observed in 81 PVs during the first-time CBA. At the repeat session, PV reconnection was only observed in 22 of 81 PVs. PV potentials disappeared with sequence changes in 36 PVs and without sequence changes in 38 PVs. Multivariate analysis demonstrated that disappearance of PV potentials without change in the EP site but with delay or disappearance of other PV potentials was independently associated with PV reconnection (12/22 PVs [55%] vs. 4/59 PVs [6.8%]; odds ratio 14.4; 95% confidence interval 3.75–55.5;
p
< 0.001). In 19 of 22 (86%) reconnected PVs, PV conduction gap sites at repeat ablation corresponded with the last remaining EP sites during first-time CBA. In conclusion, disappearance pattern of the PV potential and the last remaining EP during the CBA can predict PV reconnection and gap site.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>33496818</pmid><doi>10.1007/s00380-021-01785-3</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-2373-7059</orcidid></addata></record> |
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| subjects | Ablation Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Conduction Confidence intervals Fibrillation Medicine Medicine & Public Health Multivariate analysis Original Article Vascular Surgery |
| title | Disappearance pattern and the last remaining earliest pulmonary vein potential during cryoballoon ablation in predicting recurrence and conduction gap site of pulmonary veins |
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