• Takatoshi Shigeta, Kaoru Okishige, Yasuteru Yamauchi, Hideshi Aoyagi, Tomofumi Nakamura, Mitsumi Yamashita, Takuro Nishimura, Naruhiko Ito, Yusuke Tsuchiya, Mitsutoshi Asano, Tsukasa Shimura, Hidetoshi Suzuki, Manabu Kurabayashi, Takehiko Keida, Tetsuo Sasano, and Kenzo Hirao.
• Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan.
• J. Cardiovasc. Electrophysiol. 2017 Sep 1; 28 (9): 1021-1027.

IntroductionPulmonary vein isolation (PVI) using a cryoballoon (CB) is a useful tool for treating atrial fibrillation (AF); however, the clinical efficacy of the CB has never been fully investigated in patients with a left common pulmonary vein (LCPV).Methods And ResultsThree hundred twenty-four consecutive paroxysmal AF patients underwent PVI with a CB. Three-dimensional computed tomography was performed in all patients before the ablation. The clinical outcomes of the AF ablation between patients with (Group A) and without an LCPV (Group B) were compared. An LCPV was observed in 27 (8%) patients. There were no significant differences in the procedure time (149 ± 45 min vs. 143 ± 40 min, respectively; P = 0.42) and percentage needing touch up ablation between the 2 groups (26% vs. 20%, respectively; P = 0.45). At a mean follow-up of 454 ± 195 days, 282 of 324 (87%) patients were free from any atrial tachyarrhythmias (ATs) after a single procedure. Twenty out of 27 (74%) Group A patients and 262 of 297 (88%) Group B patients were free from ATs (15-month Kaplan-Meier event free rate estimates, 77% and 89%, respectively; P = 0.02). A multivariate analysis identified the presence of an LCPV and the left atrial diameter as reliable predictors of recurrent ATs.ConclusionsThe long-term clinical outcomes of ablation of AF with the CB was worse in patients with an LCPV than in those without. The presence of an LCPV and the LA size seemed to be reliable predictors of a worse outcome.© 2017 Wiley Periodicals, Inc.

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