Pulmonary Veins to Left Atrium Cycle Length Gradient Predicts Procedural and Clinical Outcomes of Persistent Atrial Fibrillation Ablation

Atrial Fibrillation Monday, June 9th, 2014

CIRCEP: May 14, 2014

Background—Rapid pulmonary vein (PV) activity has been shown to maintain paroxysmal AF. We evaluated in persistent AF (PsAF) the cycle length (CL) gradient between PVs and the left atrium (LA) in an attempt to identify the subset of patients where PVs play an important role.

Methods and Results—97 consecutive patients undergoing first ablation for PsAF were studied. For each PV, the CL of the fastest activation was assessed over 1 min (PVfast) using Lasso recordings. The PV to LA CL gradient was quantified by the ratio of PVfast to LA appendage (LAA) AFCL. Stepwise ablation terminated AF in 73 patients (75%). In the AF Termination group, the PVfast CL was much shorter than the LAA CL resulting in lower PVfast/LAA ratios compared to the Non-termination group (71±10% vs 92±7%, p<0.001). Read More

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