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Pulmonary vein (PV) isolation (PVI) is the corner stone in the ablation of atrial fibrillation. However recurrence of PV conduction occurs quite frequently. The study aim was to evaluate whether the assessment of PVI reconnection is dependent on the applied mapping modality.
A total of 12 patients aged 62.3 ±14.9 (50% male) undergoing a repeat ablation procedure because of recurrence of atrial fibrillation were examined. The recovery of pulmonary vein conduction was assessed using 2 different mapping systems (RHYTHMIA™ Mapping System, Boston Scientific, Inc, Cambridge, MA and CARTO® 3 System CONFIDENSE™ Module, Biosense Webster, Diamond Bar CA). The result was considered concordant if both system demonstrated reconnection (or isolation) of the PV and discordant if this was only present in one system. In addition the morphology of the veins was assessed (Diameter, Area, Branching).
The PVs were more frequently considered non isolated with the RHYTHMIA™ system when compared to the CONFIDENSE™ System and a reconnection was present in at least one pulmonary vein in 91.6% of the patients. The amount of discordant results was dependant on the location of the pulmonary vein: left superior and inferior pulmonary vein in 12,5% each, right superior vein 18.8% and right inferior in 25%. With respect to the morphology of the vein only a smaller diameter in the left inferior vein was predictive for discordance, all the other parameter remained not significant for all veins.
The assessment of reconnection after PVI is dependent on the applied mapping modality and is more often seen with the RHYTHMIA™ system when compared to the CONFIDENSE™ .