Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation
BackgroundThe achievement of first-pass isolation (FPI) during pulmonary vein isolation (PVI) generally serves as a reliable marker of lesion quality in initial radiofrequency encirclement and predicts favorable procedural outcomes. This study sought to evaluate the impact of the FPI on the long-ter...
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Frontiers Media S.A.
2025-06-01
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| author | Chenxu Luo Chenxu Luo Chenxu Luo Bing Leng Bing Leng Xinzhi Yu Xinzhi Yu Xinzhi Yu Xianfeng Du Xianfeng Du Huimin Chu Huimin Chu Shenyuan Zhou Shenyuan Zhou Shenyuan Zhou Caijie Shen Caijie Shen Mingjun Feng Mingjun Feng Yongxing Jiang Yongxing Jiang He Jin He Jin Guohua Fu Guohua Fu Lipu Yu Lipu Yu Binhao Wang Binhao Wang Yibo Yu Yibo Yu Weidong Zhuo Weidong Zhuo Fang Gao Fang Gao Yin Xu Yin Xu Yijun Sun Yijun Sun Yijun Sun Jiating Dai Jiating Dai Jiating Dai Luigi Di Biase |
| author_facet | Chenxu Luo Chenxu Luo Chenxu Luo Bing Leng Bing Leng Xinzhi Yu Xinzhi Yu Xinzhi Yu Xianfeng Du Xianfeng Du Huimin Chu Huimin Chu Shenyuan Zhou Shenyuan Zhou Shenyuan Zhou Caijie Shen Caijie Shen Mingjun Feng Mingjun Feng Yongxing Jiang Yongxing Jiang He Jin He Jin Guohua Fu Guohua Fu Lipu Yu Lipu Yu Binhao Wang Binhao Wang Yibo Yu Yibo Yu Weidong Zhuo Weidong Zhuo Fang Gao Fang Gao Yin Xu Yin Xu Yijun Sun Yijun Sun Yijun Sun Jiating Dai Jiating Dai Jiating Dai Luigi Di Biase |
| author_sort | Chenxu Luo |
| collection | DOAJ |
| description | BackgroundThe achievement of first-pass isolation (FPI) during pulmonary vein isolation (PVI) generally serves as a reliable marker of lesion quality in initial radiofrequency encirclement and predicts favorable procedural outcomes. This study sought to evaluate the impact of the FPI on the long-term clinical outcomes in persistent atrial fibrillation (PeAF) patients undergoing radiofrequency ablation.MethodsWe conducted a retrospective analysis of 346 patients with PeAF who were divided into three groups: patients with FPI in bilateral PVs (BOTH group, n = 197), those with FPI in either ipsilateral PVs (EITHER group, n = 92), and those without FPI in bilateral PVs (NEITHER group, n = 57). Achieving FPI in at least one of the two ipsilateral PVs (at least ipsilateral FPI, IFPI) was utilized as a metric for evaluation. The primary endpoint was freedom from atrial tachyarrhythmias (ATAs) lasting longer than 30s beyond the blanking period. Baseline characteristics, procedural results and long-term clinical outcomes were compared among the groups.ResultThe FPI was effectively achieved in 251 left PVs (72.5%) and 235 right PVs (67.9%). After a median follow-up of 658(402, 970) days, the NEITHER group exhibited less freedom from ATAs recurrence than the BOTH group (57.9% vs. 75.1%, P < 0.001) or the EITHER group (57.9% vs. 70.7%, P = 0.036). IFPI was an independent predictor of freedom from ATAs recurrence in PeAF patients undergoing their initial ablation (HR, 0.46; 95% CI, 0.29–0.74; P = 0.001).ConclusionAchieving FPI for PVI remained a significant association with improved ablation outcomes in PeAF patients, wherein IFPI served as an important determinant. |
| format | Article |
| id | doaj-art-ef58eb26b80a4ece9212788f32824a0e |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-ef58eb26b80a4ece9212788f32824a0e2025-08-20T03:24:47ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-06-011210.3389/fcvm.2025.15887161588716Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillationChenxu Luo0Chenxu Luo1Chenxu Luo2Bing Leng3Bing Leng4Xinzhi Yu5Xinzhi Yu6Xinzhi Yu7Xianfeng Du8Xianfeng Du9Huimin Chu10Huimin Chu11Shenyuan Zhou12Shenyuan Zhou13Shenyuan Zhou14Caijie Shen15Caijie Shen16Mingjun Feng17Mingjun Feng18Yongxing Jiang19Yongxing Jiang20He Jin21He Jin22Guohua Fu23Guohua Fu24Lipu Yu25Lipu Yu26Binhao Wang27Binhao Wang28Yibo Yu29Yibo Yu30Weidong Zhuo31Weidong Zhuo32Fang Gao33Fang Gao34Yin Xu35Yin Xu36Yijun Sun37Yijun Sun38Yijun Sun39Jiating Dai40Jiating Dai41Jiating Dai42Luigi Di Biase43Arrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaHealth Science Center, Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaDepartment of Cardiology, Ningbo Taikang Hospital, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaHealth Science Center, Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaHealth Science Center, Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaHealth Science Center, Ningbo University, Ningbo, ChinaArrhythmia Center, The First Affiliated Hospital of Ningbo University, Ningbo First Hospital, Ningbo, ChinaKey Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, The First Affiliated Hospital of Ningbo University, Ningbo, ChinaHealth Science Center, Ningbo University, Ningbo, ChinaMontefiore Medical Center, Albert Einstein College of Medicine, New York, NY, United StatesBackgroundThe achievement of first-pass isolation (FPI) during pulmonary vein isolation (PVI) generally serves as a reliable marker of lesion quality in initial radiofrequency encirclement and predicts favorable procedural outcomes. This study sought to evaluate the impact of the FPI on the long-term clinical outcomes in persistent atrial fibrillation (PeAF) patients undergoing radiofrequency ablation.MethodsWe conducted a retrospective analysis of 346 patients with PeAF who were divided into three groups: patients with FPI in bilateral PVs (BOTH group, n = 197), those with FPI in either ipsilateral PVs (EITHER group, n = 92), and those without FPI in bilateral PVs (NEITHER group, n = 57). Achieving FPI in at least one of the two ipsilateral PVs (at least ipsilateral FPI, IFPI) was utilized as a metric for evaluation. The primary endpoint was freedom from atrial tachyarrhythmias (ATAs) lasting longer than 30s beyond the blanking period. Baseline characteristics, procedural results and long-term clinical outcomes were compared among the groups.ResultThe FPI was effectively achieved in 251 left PVs (72.5%) and 235 right PVs (67.9%). After a median follow-up of 658(402, 970) days, the NEITHER group exhibited less freedom from ATAs recurrence than the BOTH group (57.9% vs. 75.1%, P < 0.001) or the EITHER group (57.9% vs. 70.7%, P = 0.036). IFPI was an independent predictor of freedom from ATAs recurrence in PeAF patients undergoing their initial ablation (HR, 0.46; 95% CI, 0.29–0.74; P = 0.001).ConclusionAchieving FPI for PVI remained a significant association with improved ablation outcomes in PeAF patients, wherein IFPI served as an important determinant.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1588716/fullpersistent atrial fibrillationpulmonary vein isolationfirst-pass isolationradiofrequency ablationablation outcome |
| spellingShingle | Chenxu Luo Chenxu Luo Chenxu Luo Bing Leng Bing Leng Xinzhi Yu Xinzhi Yu Xinzhi Yu Xianfeng Du Xianfeng Du Huimin Chu Huimin Chu Shenyuan Zhou Shenyuan Zhou Shenyuan Zhou Caijie Shen Caijie Shen Mingjun Feng Mingjun Feng Yongxing Jiang Yongxing Jiang He Jin He Jin Guohua Fu Guohua Fu Lipu Yu Lipu Yu Binhao Wang Binhao Wang Yibo Yu Yibo Yu Weidong Zhuo Weidong Zhuo Fang Gao Fang Gao Yin Xu Yin Xu Yijun Sun Yijun Sun Yijun Sun Jiating Dai Jiating Dai Jiating Dai Luigi Di Biase Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation Frontiers in Cardiovascular Medicine persistent atrial fibrillation pulmonary vein isolation first-pass isolation radiofrequency ablation ablation outcome |
| title | Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation |
| title_full | Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation |
| title_fullStr | Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation |
| title_full_unstemmed | Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation |
| title_short | Impact of the first-pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation |
| title_sort | impact of the first pass pulmonary vein isolation on ablation outcomes in persistent atrial fibrillation |
| topic | persistent atrial fibrillation pulmonary vein isolation first-pass isolation radiofrequency ablation ablation outcome |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1588716/full |
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