Atrial electroanatomical remodeling as a determinant of different outcomes between two current ablation strategies: Circumferential pulmonary vein isolation vs pulmonary vein isolation

Abstract

Background: The purpose of this study was to investigate the relationship between the efficacy of the 2 different ablation techniques of atrial fibrillation (AF) and left atrial (LA) size. Methods and Results: A total of 81 patients with paroxysmal AF (n = 58) or persistent AF (n = 23) refractory to antiarrhythmic drugs underwent circumferential pulmonary vein isolation (PVI; n = 45) or PVI (n = 36) without respect to echocardiographic results for LA volume index (LAVI).Of the 81 patients,41 had less dilated LA (group 1; LAVI <27 cc/m2) and 40 had dilated LA (group 2; LAVI≥27 cc/m2). During the 9-month follow-up, 33 patients (73.3%) after circumferential PVI and 18 (50%) after PVI (P = .031) were free of arrhythmia. The risk of recurrence was associated with persistent AF, hypertension, LAVI>27 ml/m2, PVI, early recurrence of AF, and lower left ventricular (LV) ejection fraction (all P value