Distance between the descending aorta and the left inferior pulmonary vein as a determinant of biophysical parameters during paroxysmal atrial fibrillation cryoablation

Introduction The distance from the descending aorta (DA) to the posterior wall of the left atrium (LA) is variable. We aimed to determine whether the proximity between the DA and the left inferior pulmonary vein (LIPV) ostium has an impact on biophysical parameters and cryoballoon (CB) ablation effi...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2021-11, Vol.32 (11), p.2943-2952
Main Authors: Benali, Karim, Da Costa, Antoine, Macle, Laurent, Hammache, Nefissa, Galand, Vincent, Romeyer, Cécile, Guichard, Jean Baptiste, Leclercq, Christophe, Pavin, Dominique, Martins, Raphaël
Format: Article
Language:English
Subjects:
Ablation
Aged
Aorta
Aorta, Thoracic
aortic imprint
atrial fibrillation
Atrial Fibrillation - diagnostic imaging
Atrial Fibrillation - surgery
Bioengineering
blood flow
Cardiac arrhythmia
Catheter Ablation - adverse effects
Computed tomography
Coronary vessels
cryoablation
cryoballoon
cryolesion
Cryosurgery - adverse effects
Female
Fibrillation
Freezing
Humans
left inferior pulmonary vein
Life Sciences
Male
Middle Aged
Patients
Pulmonary Veins - diagnostic imaging
Pulmonary Veins - surgery
Recurrence
Retrospective Studies
temperature
Treatment Outcome
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Summary:Introduction The distance from the descending aorta (DA) to the posterior wall of the left atrium (LA) is variable. We aimed to determine whether the proximity between the DA and the left inferior pulmonary vein (LIPV) ostium has an impact on biophysical parameters and cryoballoon (CB) ablation efficacy during LIPV freezing. Methods Patients referred for CB‐ablation of atrial fibrillation (AF) in two high‐volume centers were included. Cryoablation data were collected prospectively for each patient. The anatomical relationships between the LIPV and the DA (distance LIPV ostium‐DA, presence of an aortic imprint on the posterior aspect of the LIPV) were then retrospectively analysed on the LA computed tomography scans realized before AF ablation. Results A total of 350 patients were included (70% men, 59.7 ± 11.5 years). The decrease in the Ostium‐DA distance was significantly correlated to the increase in the time‐to‐isolation (TTI) (r = −.31; p = .036), with less negative temperature (r = −.11; p = .045). Similarly, the presence of an aortic imprint on the LIPV was associated with a longer TTI (p 
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.15234