title: Clinical implications of and factors influencing dissociated pulmonary vein potentials.
abstract: BACKGROUND
  Factors influencing dissociated pulmonary vein (PV) potentials (DPVPs) in atrial fibrillation (AF) patients undergoing circumferential PV isolation have not been investigated. Furthermore, the clinical implications of such DPVPs remain controversial.
  
  
  METHODS
  Circumferential PV isolation as a first ablation procedure was performed in 688 consecutive patients with AF (460 men; mean age, 58.9±10.5 years). The clinical implications of and factors influencing DPVPs were evaluated.
  
  
  RESULTS
  Acute PV isolation was achieved in 679 (98.7%) patients. A total of 578 (42.6%) ipsilateral PVs with DPVPs were documented in 378 (55.7%) patients (DPVPs group). Multivariate analysis revealed that male gender [odds ratio (OR): 1.894; 95% confidence interval (CI): 1.344-2.667; p<0.001] and paroxysmal AF (OR: 1.715; 95% CI: 1.182-2.488; p=0.005) were independent factors for DPVPs. The incidence of acute and intraoperative PV reconnection (PVR) was higher in the DPVPs group than in the non-DPVPs group (33.1% vs. 17.9%; p<0.001 and 44.4% vs. 28.2%; p<0.001). After the first procedure, 244 (65.6%) DPVPs-group patients and 168 (56.4%; p=0.015) non-DPVPs group patients were free from AF recurrence. During repeat procedures, PVR incidence was similar in the DPVPs group (81.8%) and non-DPVPs groups (83.3%; p=0.863).
  
  
  CONCLUSIONS
  Male gender and paroxysmal AF were independent risk factors for DPVPs in patients undergoing circumferential PV isolation. DPVPs had a significant impact on acute and intraoperative PVR. The outcomes of the first ablation procedure were better in patients with DPVPs.
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Songwen
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Haiqing
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Meng
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Genqing
authors.initials: G
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Baozhen
authors.initials: B
authors.lastname: Qi
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University, No 100, Haining Road, Shanghai 200080, China. Electronic address: shaowen.liu@hotmail.com.
authors.forename: Shaowen
authors.initials: S
authors.lastname: Liu
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D012737:Sex Factors
keywords: Atrial fibrillation; Circumferential pulmonary vein isolation; Dissociated pulmonary vein potentials; Pulmonary vein; Pulmonary vein reconnection