Reablated Sites of Acute Reconnection After Pulmonary Vein Isolation Do Not Predict Sites of Late Reconnection at Repeat Electrophysiology Study

Journal of Cardiovascular Electrophysiology
Moloy DasDhiraj Gupta

Abstract

Acute reconnection of pulmonary veins (PVs) is frequently seen in the waiting period following pulmonary vein isolation (PVI). There are concerns that reablation at these sites may not be durably effective due to tissue edema caused by the initial ablation. We aimed to prospectively study the relationship between acute and late reconnection. Wide-area circumferential PVI was performed in 40 paroxysmal AF patients. Spontaneous reconnection was assessed after a minimum 20-minute waiting period, with adenosine administered to unmask dormant reconnection. All sites of acute reconnection were ablated to reisolate the PV. All 40 patients then underwent repeat electrophysiology study after 2 months, regardless of symptoms, to identify late reconnection. Sites of acute and late reconnection were compared according to a 12-segment PVI model. Acute reconnection was seen in 28 (6%) PVI segments in 20 (50%) patients, affecting 24/160 (15%) PVs. All were successfully reisolated. At repeat electrophysiology study, 51 (11%) PVI segments were reconnected in 25 (62%) patients, affecting 41 (25%) PVs. The proportion of PVI segments with and without acute reconnection exhibiting late reconnection at repeat study was no different (14% vs. 10%, P =...Continue Reading

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Citations

Jun 2, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Moloy DasDhiraj Gupta
Jun 24, 2017·Journal of Cardiovascular Electrophysiology·Ahmed HusseinDhiraj Gupta
Jan 13, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Dhiraj Gupta
Mar 27, 2019·Pacing and Clinical Electrophysiology : PACE·Alonso PedroteEduardo Arana-Rueda
Jan 9, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Ivan ZeljkovicChristian Sticherling
Sep 11, 2019·Journal of Cardiovascular Electrophysiology·Tao ZhangXuejun Ren
Apr 8, 2021·Journal of Cardiovascular Electrophysiology·Jose OsorioGustavo Morales

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