Isolating the entire pulmonary venous component versus isolating the pulmonary veins for persistent atrial fibrillation: A propensity‐matched analysis

Background The outcomes of pulmonary vein isolation (PVI) for persistent atrial fibrillation (AF) are suboptimal. The entire pulmonary venous component (PV‐Comp), consisting of the pulmonary veins, their antra, and the area between the antra, provides triggers and substrate for AF. PV‐Comp isolation...

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Published in:Pacing and clinical electrophysiology 2020-01, Vol.43 (1), p.68-77
Main Authors: Elbatran, Ahmed I, Gallagher, Mark M, Li, Anthony, Sohal, Manav, Bajpai, Abhay, Samir, Rania, Tawfik, Mazen, Nabil, Ahmed, Abou‐Elmaaty Nabih, Mervat, Saba, Magdi M
Format: Article
Language:English
Subjects:
Aged
Atrial Fibrillation - surgery
Cardiac arrhythmia
catheter ablation
Catheter Ablation - methods
Egypt
Electrocardiography
Epicardial Mapping
Female
Fibrillation
Fluoroscopy
Humans
London
Male
Middle Aged
persistent atrial fibrillation
posterior wall isolation
Propensity Score
pulmonary vein isolation
Pulmonary Veins - surgery
pulmonary venous component
Recurrence
Tachyarrhythmia
Tachycardia
Veins & arteries
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Summary:Background The outcomes of pulmonary vein isolation (PVI) for persistent atrial fibrillation (AF) are suboptimal. The entire pulmonary venous component (PV‐Comp), consisting of the pulmonary veins, their antra, and the area between the antra, provides triggers and substrate for AF. PV‐Comp isolation is an alternative strategy for persistent AF ablation. Methods Among 328 patients with persistent AF who underwent a first radiofrequency ablation procedure, 200 patients (PVI, n = 100; PV‐Comp isolation, n = 100) were selected by propensity score matching. Both groups were followed up for 1 year. Results At 6‐ and 12‐month follow‐up, atrial tachyarrhythmia (AF/atrial tachycardia) recurred in 41 and 61 patients in PVI group and 22 (P = .006) and 33 patients (P 
ISSN:0147-8389
1540-8159
DOI:10.1111/pace.13852