Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-139 - The Last Remaining Earliest Pulmonary Vein Potential Just Before Pulmonary Vein Isolation During Cryoballoon Ablation Predicts The Conduction Gap Site Of The Pulmonary Vein (ID 337)


Background: Electrophysiological studies have rarely evaluated the site prone to pulmonary vein (PV) conduction gap later in cryoballoon ablation (CBA) for atrial fibrillation (AF).
Objective: This study aimed to investigate the relationship between the last remaining earliest pulmonary vein potential (EP) during first-time CBA for AF and the conduction gap site of the PV.
Methods: We evaluated 80 consecutive patients who underwent first-time CBA for paroxysmal AF. We evaluated time-to-isolation (TTI) and the sequence of PV potentials during cryoapplication and analyzed whether the PV conduction gap site at re-ablation and the last remaining EP site just before PV isolation during first-time CBA corresponded.
Results: All 318 PVs were isolated successfully during first-time CBA using a second-generation balloon. TTI was noted in 175 PVs and the PV sequence changed during cryoapplication in 74 PVs (42%). Twelve patients (15%) experienced arrhythmic recurrences within 12 months of the procedure and re-ablation was performed in these patients. PV conduction gaps were identified in 10 patients during re-ablation. During first-time CBA, TTI could be observed in 7 patients with 8 reconnected PVs. These 8 reconnected PV conduction gap sites at re-ablation corresponded with the last remaining EP sites during the first CBA.
Conclusion: The sequence of PV potentials during cryoapplication may change before the disappearance of PV potentials. The last remaining EP site just before PV isolation during CBA for AF corresponded with the PV conduction gap site later.