title: Anatomical predictors for successful pulmonary vein isolation using balloon-based technologies in atrial fibrillation.
abstract: OBJECTIVE
  We evaluated the correlation between pulmonary venous (PV) anatomy and acute and long-term success of PV isolation (PVI) with two balloon-based ablation catheter techniques.
  
  
  METHODS
  One hundred consecutive patients were analyzed in two equal groups treated with either the second-generation cryoballoon (CRYO) catheter or the visually guided laser ablation (VGLA) catheter. All patients underwent multi-detector computed tomography (CT) imaging. The primary and secondary efficacy endpoints were the procedural achievement of proven electrical isolation of all veins and freedom from atrial fibrillation (AF) within a 1-year follow-up period, respectively.
  
  
  RESULTS
  Variant PV anatomy was observed in 32% of patients in the CRYO group and in 40% of patients in the VGLA group. All PVs were targeted with either the CRYO catheter (n = 199) or the VGLA catheter (n = 206). One hundred ninety-three of 199 PVs (97%) were successfully isolated in the CRYO group and 194 of 206 PVs (94%) in the VGLA group (p = 0.83). Over a 12-month follow-up, AF recurrence was documented in 11/45 (24%) and 7/43 (16%) patients in the CRYO and the VGLA groups, respectively (p = 0.21). In the CRYO group, a larger left inferior PV size was associated with worse long-term outcome (p = 0.001). In the VGLA group, a larger left superior PV size (p = 0.003) and more oval right inferior PV were associated with worse acute success (p = 0.038). There was no absolute cutoff between PV anatomy and clinical success.
  
  
  CONCLUSIONS
  The variability of PV anatomy did not significantly compromise acute success of PVI or patient outcomes.
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic. tsyganov.alexey@gmail.com.|Petrovsky National Research Centre of Surgery, Moscow, Russia. tsyganov.alexey@gmail.com.
authors.forename: Alexey
authors.identifier: http://orcid.org/0000-0002-6667-0539
authors.initials: A
authors.lastname: Tsyganov
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Petru
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Skoda
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Lucie
authors.initials: L
authors.lastname: Sediva
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Hala
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Weichet
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Janotka
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Chovanec
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Neuzil
authors.affiliation: The Helmsley Electrophysiology Centre, Mount Sinai School of Medicine, New York, NY, US.
authors.forename: Vivek Y
authors.initials: VY
authors.lastname: Reddy
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000601:surgery*; D062906:Cardiac Catheters; D003452:Cryosurgery / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000528:radiation effects / Q000601:surgery; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Atrial fibrillation; CRYO ablation; Laser ablation; Pulmonary vein anatomy