Differences in the durability of left atrial posterior wall isolation based on the isolation process

• Published in: Journal of interventional cardiac electrophysiology 2022-10, Vol.65 (1), p.45-51
• Main Authors: Tamura, Shota, Shimeno, Kenji, Nakatsuji, Kenichi, Hayashi, Yusuke, Abe, Yukio, Naruko, Takahiko
• Format: Article
• Language: English
• Subjects: Ablation; Cardiology; Durability; Medicine; Medicine & Public Health; Multivariate analysis
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1007/s10840-021-01108-6

Purpose The best strategy for durable left atrial posterior wall isolation (PWI) after completion of pulmonary vein isolation (PVI) is not yet determined. This study aimed to examine the differences in the durability of PWI based on the isolation process and the predictors of the reconduction of PWI. Methods Among the 221 patients (mean age, 65 ± 11 years) with consecutive non-paroxysmal atrial fibrillation (AF) who completed PVI and PWI, 50 patients undergoing repeat AF ablation were enrolled and divided into the following groups based on how PWI was achieved at the initial procedure: by only the first line on the roof and floor line (group A), by additional gap ablation to the first line or second liner ablation next to the first line (group B), and by adjunct ablation inside the PW revealing the earliest activation (group C). Results Reconduction of PWI occurred in 24 of the 50 patients (48%). The durability of PWI in groups A, B, and C was 81% (17 of 21 patients), 75% (6 of 8 patients), and 14% (3 of 21 patients), respectively ( p