Epicardial Connections Between the Pulmonary Veins and Left Atrium: Relevance for Atrial Fibrillation Ablation

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dc.contributor.authorPérez Castellano, Nicasio
dc.contributor.authorPérez Villacastín Domínguez, Julián
dc.contributor.authorSalinas, Jorge
dc.contributor.authorVega, Mercedes
dc.contributor.authorMoreno, Javier
dc.contributor.authorDoblado, Manuel
dc.contributor.authorRuiz, Eduardo
dc.contributor.authorMacaya Miguel, Carlos
dc.date.accessioned2024-02-09T11:04:15Z
dc.date.available2024-02-09T11:04:15Z
dc.date.issued2011-02-01
dc.description.abstractEpicardial Connections Between PVs and the LA. Introduction: Some observations support the existence of epicardial connections (ECs) between ipsilateral pulmonary veins (vein to vein ECs [VVECs]), and we have observed venoatrial ECs inserted at distance from the pulmonary vein ostium (vein to atrium ECs [VAECs]). Our aim was to determine the prevalence of ECs and their relevance for pulmonary vein isolation. Methods and Results: We studied 100 consecutive patients with drug-refractory atrial fibrillation who underwent ostial pulmonary vein isolation by cooled radiofrequency catheter ablation. A VVEC was identified if pulmonary vein pacing activated the ipsilateral vein before the atrium, requiring ablation of both venous ostia to isolate either pulmonary vein. A VAEC was identified if pacing produced atrial breakthrough located at distance from the venous ostium, requiring extraostial ablation to isolate the pulmonary vein. Patients with ECs (20%) were younger (P = 0.02) and had a higher prevalence of structural heart disease (P = 0.01) than patients without ECs. VVECs and VAECs were identified in 32 pulmonary veins (10%) and VAECs in 10 veins (3%). Veins with ECs had a higher rate of early recurrence of conduction following isolation (29% vs 11%; P = 0.01). Conclusion: Twenty percent of patients with atrial fibrillation had ECs resistant to ostial ablation in one or more pulmonary veins. Isolating veins with ECs may require a different ablation approach. These connections are associated with an increased rate of early recurrence of conduction.
dc.description.departmentDepto. de Medicina
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.statuspub
dc.identifier.citationPérez-Castellano N, Villacastín J, Salinas J, Vega M, Moreno J, Doblado M, Ruiz E, Macaya C. Epicardial connections between the pulmonary veins and left atrium: relevance for atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2011 Feb;22(2):149-59. doi: 10.1111/j.1540-8167.2010.01873.x. Epub 2010 Aug 30. PMID: 20807282.
dc.identifier.doi10.1111/j.1540-8167.2010.01873.x
dc.identifier.issn1045-3873
dc.identifier.officialurlhttps://onlinelibrary.wiley.com/doi/10.1111/j.1540-8167.2010.01873.x
dc.identifier.pmid20807282
dc.identifier.relatedurlhttps://pubmed.ncbi.nlm.nih.gov/20807282/
dc.identifier.urihttps://hdl.handle.net/20.500.14352/100838
dc.issue.number2
dc.journal.titleJournal of Cardiovascular Electrophysiology
dc.language.isoeng
dc.page.final159
dc.page.initial149
dc.publisherWiley
dc.rights.accessRightsrestricted access
dc.subject.cdu616.12
dc.subject.keywordatrial fibrillation
dc.subject.keywordcatheter ablation
dc.subject.keywordepicardium
dc.subject.keywordpulmonary vein
dc.subject.keywordisolation
dc.subject.ucmCardiología
dc.subject.unesco32 Ciencias Médicas
dc.titleEpicardial Connections Between the Pulmonary Veins and Left Atrium: Relevance for Atrial Fibrillation Ablation
dc.typejournal article
dc.type.hasVersionVoR
dc.volume.number22
dspace.entity.typePublication
relation.isAuthorOfPublication85f05732-b64c-4cc3-a1d8-9d7f1a7e9c4c
relation.isAuthorOfPublication8c248da7-c733-4a61-9767-52bbfd91fc91
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relation.isAuthorOfPublication.latestForDiscovery85f05732-b64c-4cc3-a1d8-9d7f1a7e9c4c
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