Cryoballoon in AF ablation: Impact of PV ovality on AF recurrence

Impact of pulmonary vein ostia anatomy on efficacy of cryoballoon ablation for atrial fibrillation

“…Sorgente et al [5] reported that vein ostium ovality and orientation predicted the degree of PV occlusion, especially in the left-sided PV. However, that study did not provide any data on efficacy of the procedure, and the ovality index was calculated using a different formula than that used in our study, which may account for the discrepant results of our study and that of Sorgente et al Also Schmidt et al [6] suggested that the ovality index predicted complete occlusion and AF recurrences after ablation. Their study differed from ours in having more patients included in the analysis and closer follow-up (7-day Holter ECGs).…”

“…The PV ostium area and ovality index were measured according to Schmidt et al [6] . After CT segmentation, the PV were measured at the ostial level.…”

“…Due to the fact that the size and shape of the balloon are predefined, PV anatomy, including number of veins, presence of common trunk, angulation, ostium area and ovality, may have an impact on CB ablation efficacy. A few studies which addressed this issue provided inconsistent results [2][3][4][5][6] . Therefore, the aim of our study was to examine whether PV ostia anatomy is related to the acute and long-term effects of CB of AF.…”

Effect of left atrial volume and pulmonary vein anatomy on outcome of nMARQ™ catheter ablation of paroxysmal atrial fibrillation

“…They found no correlation between anatomy and clinical outcome. Schmidt et al [21] investigated the role of PV ostial anatomy during cryoballoon PV occlusion and consequent AF recurrence rate.…”

Lessons From Radiofrequency Redo-Procedure After Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

“…This is particularly true for the LIPV, for which the ostium usually presents an oval shape and the diameter is smaller than the superior veins, when using the 28-mm balloon (Figure 4). 9 Because of the lack of congruence between a round non-deformable balloon and an oval LIPV ostium, good tissue contact may be difficult to obtain at the inferior part of the vein. This mechanism likely explained the high rate of PV reconduction observed at this site of the LIPV (overall…”