Acute and chronic pulmonary vein reconnection after atrial fibrillation ablation: A prospective characterization of anatomical sites

Abstract

Background: Arrhythmia recurrence after atrial fibrillation (AF) ablation is often associated with pulmonary vein reconnection (PVR). We prospectively examined anatomical sites of both acute and chronic PVR. Methods: One hundred and fifty AF patients underwent PV wide encirclement and sites where immediate electrical isolation (EI) occurred were tagged using electroanatomic mapping/CT integration (Cartomerge™, Biosense Webster, Diamond Bar, CA, USA). After 30 minutes PVs were checked and acute PVR sites marked at reisolation. Chronic PVR sites were marked at the time of repeat procedures. Results: On the left, immediate EI sites were predominantly on the intervenous ridge (IVR) and PV-left a..