Details

Autor(en) / Beteiligte

• Hori, Hitomi
• Kaneko, Shinji
• Fujita, Masaya
• Nagai, Shin
• Ito, Ryota
• Shirai, Yoshinori
• Adachi, Kentaro
• Suzuki, Noriyuki
• Suzuki, Junya
• Kondo, Kiyota
• Yamauchi, Ryota
• Haga, Tomoaki
• Tatami, Yosuke
• Ohashi, Taiki
• Kubota, Ryuji
• Shinoda, Masanori
• Tanaka, Akihito
• Inden, Yasuya
• Murohara, Toyoaki

Titel

The ridge line of left pulmonary vein isolation from left atrial appendage can subsequently increase the completion rate of the mitral isthmus block line

Ist Teil von

• Journal of interventional cardiac electrophysiology, 2023-04, Vol.66 (3), p.673-681

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Background and objectives Mitral isthmus (MI) ablation for mitral flutter is technically difficult, and incomplete block line is not uncommon. The objective of this study is to investigate the effect of the ridge line of left pulmonary vein isolation (LPVI) from left atrial appendage (LAA) on completion rate of mitral isthmus (MI) block line and recurrence rate of atrial tachycardia (AT) or atrial flutter (AFL) after the first MI ablation. Methods We identified 611 patients who underwent first MI ablation for mitral flutter during the study period. Finally, 559 patients were enrolled and divided into two groups according to the method of ridge line ablation of LPVI (LAA group, n  = 467, conventional group, n  = 92). Outcome measures were the completion of MI block line by first MI ablation, the recurrence of AT/AFL, and repeat MI ablation after the first MI ablation. Results The first MI block line completion rate was significantly higher in the LAA group than the conventional group (95% vs. 85%, p  < 0.001). The recurrence rate of AT/AFL after 3 months from first MI ablation was significantly lower in the LAA group. The requirement of additional MI ablation tended to be lower in the LAA group. Conclusions Our novel approach of ablating LPV-LAA ridge from the LAA side during PVI can increase the success rate of MI block line completion, and reduce the recurrence rate of AT/AFL and the need for additional MI block line ablation. Graphical abstract Ablation of the left pulmonary vein-left atrial appendage ridge from the left atrial appendage side during PVI increased the success rate of mitral isthmus block line completion