Abstract
Background: Common ostium of inferior pulmonary veins (COIPV) is a kind of pulmonary vein variation. The safety and efficacy of COIPV isolation using the second-generation cryoballoon (CB) ablation remain unknown.Methods: A total of 10 patients with COIPV from a consecutive series of 1,751 patients with atrial fibrillation (AF) were included. Pulmonary vein isolation (PVI) was performed using the second-generation CB.Results: The prevalence of a COIPV was 0.57% in this study. PVI was achieved in all pulmonary veins (PVs) without the need for a touch-up. A segmental freeze strategy was applied for each inferior PV, respectively. The mean number of freeze cycles of inferior PVs was 1.4 ± 0.5 for the left inferior pulmonary vein (LIPV), and 2.0 ± 0.9 for the right inferior pulmonary vein (RIPV). Pulmonary vein potential (PVP) of RIPV could not be monitored in real-time in three cases. Eight of 10 patients (80%) were free from atrial arrhythmias without the use of antiarrhythmic drugs during a follow-up period of 23.6 ± 12.9 months. No procedure-related complications occurred in any of the 10 patients.Conclusions: Common ostium of inferior pulmonary veins is a rare but challenging PV variant. PVI with this unusual anatomic variation using the second-generation 28-mm CB is effective and safe.
Highlights
Atrial fibrillation (AF), the most common cardiac arrhythmia, affects approximately 1–2% of the entire population [1]
The segmental ablation approach would be adopted to avoid a deep-seating of cryoballoon (CB) in a large common pulmonary vein (PV) ostium, in Cryoballoon Ablation for common ostium of inferior pulmonary veins (COIPV)
A common ostium of inferior pulmonary veins (COIPV), another kind of PV variation, is likely to present in increasing patients with AF
Summary
Atrial fibrillation (AF), the most common cardiac arrhythmia, affects approximately 1–2% of the entire population [1]. Pulmonary vein isolation (PVI) has become a well-accepted strategy and the cornerstone of AF catheter ablation [2, 3]. A common ostium of inferior pulmonary veins (COIPV), another kind of PV variation, is likely to present in increasing patients with AF. Freedom from atrial tachyarrhythmias would benefit from COIPV isolation [8]. Limited data are available about the safety and efficacy of using the second-generation CB ablation in patients with COIPV. This study aimed to explore the safety and efficacy of COIPV isolation using the secondgeneration CB in patients with AF. Common ostium of inferior pulmonary veins (COIPV) is a kind of pulmonary vein variation. The safety and efficacy of COIPV isolation using the second-generation cryoballoon (CB) ablation remain unknown
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