Baseline characteristics
Table 1 shows the baseline clinical characteristics of the present study patients. In this study, 130 patients (67% male, age 66 ± 12 years) who underwent an initial PVI with VGLA were analyzed. The mean CHA2DS2-VASc score was 2.0 ± 1.5 and mean LA diameter 38.4 ± 6.1 mm.
The RIPV could not be electrically isolated in 4 patients, because of prematurely terminating the VGLA due to the sudden failure of right phrenic nerve capture, which persisted until the end of the procedure. In all but those 4 patients, all PVs were successfully isolated. The LB ruptured in 3 patients during the procedure, and 26 patients underwent additional touch up RF ablation to achieve the PVI.
There were no significant differences in the age, gender, body mass index (BMI), or comorbidities such as hypertension, diabetes, and a history of congestive heart failure or a stroke between those with and without LCPV. The LA diameter and LVEF were also comparable. Moreover,Table 2 shows the procedural characteristics of the present study patients. The total procedure time and LB dwelling time in the LA were significantly shorter in the patients with an LCPV. There was no significant difference in the fluoroscopy time, number of ATP dormant conduction sites, and adjunctive RF touch-up ablation between the two groups. ATP dormant conduction was observed in 8 patients in the LSPV, 2 in the LIPV, 5 in the RSPV, 5 in the RIPV and none in the LCPV, respectively.
In the present study, 11 patients (8.5%) had an LCPV (LCPV ostium maximal diameter: 27.5 ± 4.9 mm, LCPV ostium minimal diameter: 17.7 ± 3.5 mm, and LCPV ovality index: 0.44 ± 0.15). The mean length between the LCPV ostium and bifurcation point of the superior and inferior PVs was 19.5 ± 3.4 mm. We could electrically isolate the LCPVs at the ostium with the VGLA in 9 patients, whereas the superior and inferior branches of the LCPV were isolated individually due to a large LCPV diameter in 2 patients. Those 2 patients had a significantly larger LCPV maximal ostium diameter than the remaining 9 patients (34.8 ± 1.1 mm vs. 25.9 ± 3.8 mm, P = 0.01).