Novel Clue to Locate the Conduction Gap on the Pulmonary Vein Isolation
Ablation Line
Abstract
BACKGROUND Several methods have been proposed to locate the conduction
gap on the pulmonary vein isolation (PVI) ablation line. However, the
value of the interval of far-field potential (FF potential) and
pulmonary vein potential (PV potential) is unknown. METHODS: The state
of PV potential and the location of that ablation sites were
particularly recorded for analysis once LSPV was isolated in a
development cohort of consecutive patients undergoing PVI ablation at a
single center. These findings informed the development of a novel
algorithm to discriminate the location of a conduction gap between upper
portion and inferior portion of LSPV. The performance of this novel
algorithm was prospectively tested in a validation cohort of consecutive
re-do patients undergoing PVI ablation RESULTS: A total one hundred
sixteen patients were recruited, of which 56 formed the validation
cohort. Interval of FF potential and PV potential was associated with
the location of the conduction gap, and the interval <5 ms
predicted that there was a conduction gap in the upper portion of ostium
with 92.9% sensitivity and 96.9% specificity. In the prospective
evaluation, the interval was able to correctly predict the site of
successful ablation in 89.6%. CONCLUSIONS: Interval of far-field
potential and pulmonary vein potential is a novel and accurate marker to
predict the location of a conduction gap.