Elias Adi, Marai Ibrahim, Eyal Alon, Darawsha Wisam, Shehadeh Faheem, Glueck Robert, Beinart Roy, Nof Eyal, Michowitz Yoav, Glikson Michael, Konstantino Yuval, Haim Moti, Luria David, Omelchenko Alexander, Laish-Farkash Avishag, Suleiman Mahmoud
Cardiac Electrophysiology and Pacing, Eyal Ofer Heart Hospital, Rambam Health Care Campus, Haifa, Israel.
Cardiology Department, Baruch Padeh Medical Center, Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
Heart Rhythm O2. 2024 Dec 14;6(3):290-298. doi: 10.1016/j.hroo.2024.12.002. eCollection 2025 Mar.
Pulmonary vein isolation (PVI) with cryoballoon technology is widely used for rhythm control in atrial fibrillation (AF). However, there are limited data on its effectiveness in patients with the left common pulmonary vein (LCPV) variant.
The study aimed to examine the outcomes of cryoballoon ablation in patients with the LCPV variant.
The Israeli Catheter Ablation Registry is a prospective, multicenter cohort that included citizens who underwent PVI during the years 2019-2021. Study endpoints were acute isolation success of the pulmonary veins (PVs), AF recurrence, and the need for a repeat ablation procedure at 12 months.
The study included 74 patients with the LCPV variant and 822 patients with standard PV anatomy. The acute isolation success rate of the LPVs was significantly lower in LCPV variant patients compared with those with a standard anatomy. However, there was no significant difference in the acute isolation success rate of the right PVs between the 2 groups. At 12 months, the rates of AF recurrence did not differ significantly between the LCPV variant group (17.6%) and the standard anatomy group (11.1%) ( .09), and multivariable adjustment LCPV was not associated with AF recurrence (hazard ratio 0.86, 95% confidence interval 0.43-1.74). Similarly, the rate of repeat ablation for recurrent AF did not differ significantly.
In our study, we found that isolating the LCPV using cryoballoon PVI was more challenging than isolating standard anatomy. Despite this, the effectiveness of cryoballoon ablation in patients with LCPV anatomy did not differ significantly from that in the standard anatomy group.
冷冻球囊技术进行肺静脉隔离（PVI）广泛用于心房颤动（AF）的节律控制。然而，关于其在左肺总静脉（LCPV）变异患者中的有效性的数据有限。
本研究旨在探讨LCPV变异患者冷冻球囊消融的结果。
以色列导管消融注册研究是一项前瞻性、多中心队列研究，纳入了2019年至2021年期间接受PVI的公民。研究终点为肺静脉（PVs）的急性隔离成功率、AF复发以及12个月时重复消融手术的必要性。
该研究纳入了74例LCPV变异患者和822例具有标准PV解剖结构的患者。与具有标准解剖结构的患者相比，LCPV变异患者中左肺静脉（LPVs）的急性隔离成功率显著较低。然而，两组之间右肺静脉的急性隔离成功率没有显著差异。在12个月时，LCPV变异组（17.6%）和标准解剖结构组（11.1%）的AF复发率没有显著差异（P = 0.09），多变量调整后LCPV与AF复发无关（风险比0.86，95%置信区间0.43 - 1.74）。同样，复发性AF的重复消融率也没有显著差异。
在我们的研究中，我们发现使用冷冻球囊PVI隔离LCPV比隔离标准解剖结构更具挑战性。尽管如此，冷冻球囊消融在LCPV解剖结构患者中的有效性与标准解剖结构组没有显著差异。
