Association Between Pulmonary Vein Anatomy And Atrial Fibrillation Recurrence After Catheter Ablation

Aims: To investigate the association between pulmonary vein anatomy and atrial fibrillation(AF)recurrence after circumferential pulmonary vein isolation.Methods: 174 consecutive patients underwent AF ablation due to drug-refractory symptomatic AF were enrolled.Prior to the procedure,all patients underwent multi-slice computed tomography(MSCT)scanning for the evaluation of PV anatomy.Systematic follow-up was performed at 1,3,6,and 12 months.The study endpoint was documented AF recurrence after a blanking period of 3 months following the day of ablation.Results: After 12 months,114 patients(65.5%)maintained sinus rhythm.In univariate analysis,AF type(P<0.001),left atrial(LA)volume(P<0.001),left lateral ridge(LLR)length(P<0.001),the longitudinal diameter of right superior PV and left superior PV(P<0.001,both),LA diameter(LAD)(P=0.001),left middle PV(LMPV)(P=0.04)and paroxysmal supraventricular tachycardia(PSVT)(P=0.028)were associated with AF recurrence.In multivariate analysis,LA volume(P=0.012),LLR length(P=0.001)and the longitudinal diameter of RSPV(P<0.001)were determined as independent predictors.Conclusion: LA volume,LLR length and the longitudinal diameter of RSPV assessed by MSCT were independent predictors of AF recurrence after CPVI.