Redo ablation results
Among the 55 patients with recurrence after the index catheter ablation
procedure, 42 patients underwent a redo ablation procedure. Of the 12
patients with AT recurrence who underwent a redo ablation, AT persisted
at the beginning of the procedure in 8 (66.6%) patients, and the type
of AT was identified in all patients. Perimitral AT circulating around
the mitral annulus was the most frequently confirmed type (4 patients).
Of these four patients with perimitral AT recurrence, cryoballoon
ablation of the LA roof was performed in the index ablation procedure in
three patients. Roof-dependent AT, which contained the LA roof in the
reentrant circuit, was observed in two patients, who both underwent
cryoballoon ablation of the LA roof in the index ablation procedure. PV
gap-related AT was confirmed in the other two patients.
The durability of each lesion created in the index ablation procedure is
described in Figure 4. The prevalence of the patients in whom all PVs
were confirmed to be durable was 57.1% (24/42 patients). Complete
conduction blocks at the LA roof, LAPW bottom, and CTI were confirmed to
be durable in 72.2% (18/25), 38.1% (8/21), and 56.8% (21/37) of
patients, respectively. The rates of lesion durability of the PVI and LA
roof lines without touch-up ablations were 59.4% (19/32) and 73.9%
(17/23) of patients, respectively. When the percentages of the lesion
durability between the patients with AT recurrence (25.0%) and those
without AT recurrence (29.4%) were compared, the prevalence of LA
roof-line recurrence was comparable (p=1.00). At the beginning of the
session, the ratio of scar area to LAPW area was significantly higher
(p<0.01) in the patients who had undergone cryoballoon
ablation (66.3 [45.8–83.1] %) of the LAPW in the index ablation as
compared to those who had not (12.2 [2.1–26.3] %).
Additional linear ablation at the LAPW, including the LA roof line, was
performed in 35 (97.2%) of 36 patients whose LAPW was not isolated at
the beginning of the redo ablation procedure. MI ablation was performed
in 19 (45.2%) of 42 patients. Of 41 patients who underwent follow-up
after-redo ablation procedure, 26 (63.4%) were free from atrial
arrhythmias after the redo ablation procedure.