Comparison of Long-Term Clinical Outcomes Between Segmental and Circumferential Pulmonary Vein Isolation in Patients Undergoing Repeat Atrial Fibrillation Ablation

Shang Ju Wu, Li Wei Lo*, Fa Po Chung, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Yu Cheng Hsieh, Cheng Hung Li, Ta Chuan Tuan, Tze Fan Chao, Jo Nan Liao, Chin Yu Lin, Ting Yung Chang, Ling Kuo, Chih Min Liu, Shin Huei Liu, Cheng I. Wu, Chi Jen Weng, Ming Jen Kuo, Guan Yi LiYu Shan Huang, Jose Antonio Bautista, Yoon Kee Siow, Nguyen Dinh Son Ngoc, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Circumferential pulmonary vein isolation (CPVI) has supplanted segmental PVI (SPVI) as standard procedure for atrial fibrillation (AF). However, there is limited evidence examining the efficacy of these strategies in redo ablations. In this study, we investigated the difference in recurrence rates between SPVI and CPVI in redo ablations for PV reconnection. Methods and Results: This study retrospectively enrolled 543 patients who had undergone AF ablation between 2015 and 2017. Among them, 167 patients (30.8%, including 128 male patients and 100 patients with paroxysmal AF) underwent redo ablation for recurrent AF. Excluding 26 patients without PV reconnection, 141 patients [90 patients of SPVI (Group 1) and 51 patients of CPVI (Group 2)] were included. The AF-free survival rates were 53.3% and 56.9% in Group 1 and Group 2, respectively (P=0.700). The atrial flutter (AFL)-free survival rates were 90% and 100% in Group 1 and Group 2, respectively (P=0.036). The ablation time was similar between groups, and there no major complications were observed. Conclusions: For redo AF ablation procedures, SPVI and CPVI showed similar outcomes, except for a higher AFL recurrence rate for SPVI after long-term follow-up (>2 years). This may be due to a higher probability of residual PV gaps causing reentrant AFL.

Original languageEnglish
Pages (from-to)1750-1756
Number of pages7
JournalCirculation Journal
Volume87
Issue number12
DOIs
StatePublished - 2023

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Circumferential isolation
  • Recurrence
  • Segmental isolation

Fingerprint

Dive into the research topics of 'Comparison of Long-Term Clinical Outcomes Between Segmental and Circumferential Pulmonary Vein Isolation in Patients Undergoing Repeat Atrial Fibrillation Ablation'. Together they form a unique fingerprint.

Cite this