Pulmonary vein isolation by cryoablation on patients with paroxysmal atrial fibrillation

Abstract

Aim: Atrial fibrillation is just one of many arrhythmias that affects the cardiac rhythm and the heart as a pump which consequently increases the chance of an embolic insult. Due to the electric stimuli that originate from pulmonary vein ostia and their lumen, an isolation procedure is initiated, mostly by cryoablation. The main goals of this study were to investigate the relationship between measured nadir temperatures during cryoablation of each individual pulmonary vein and to compare the success of first-time cryoablation between left and right pulmonary veins. Participants and methods: The study involved 40 participants who underwent pulmonary vein isolation by cryoablation due to paroxysmal atrial fibrillation, irrespective of gender and age. The procedures were carried out throughout the year 2022 at the University Hospital Centre Zagreb, where the data were collected. All necessary patient data were permanently recorded and saved in a separate cryoconsole used to dictate the entire procedure. Results: Given the 40 participants in the study, a total of 160 pulmonary veins were analyzed. The t-test shows that the left upper pulmonary vein was the most advantageous vein to isolate, and the lower right pulmonary vein was the least advantageous. p-value analysis has also shown significant differences between left and right pulmonary veins, with that difference being lower in value between the left-sided pulmonary veins. Additionally, the chi-squared test confirmed a statistically significant difference between successful cryoablations of left-sided and right-sided pulmonary veins. This has shown that the left-sided pulmonary veins are easier to isolate on first cryoablation, rather than their right-sided counterparts. Conclusion: Pulmonary vein isolation by cryoablation is an excellent proof of incorporating fundamental physical principles in medicinal purposes. This study keeps the doors open for further research into optimal approaches in atrial fibrillation treatment. Therefore, comparing our study with recent publications and literature suggests higher success in isolating left pulmonary veins compared to right pulmonary veins.