Prognostic value of pulmonary vein size in prediction of atrial fibrillation recurrence after pulmonary vein isolation: A cardiovascular magnetic resonance study

Background: the relationship between pulmonary vein (pv) anatomy and successful catheter ablation of atrial fibrillation (af) is poorly understood methods: first-pass contrast enhanced pv magnetic resonance angiography was performed in 71 consecutive patients prior to pv isolation. pv diameter and cross-sectional area (csa) were measured prior to pv isolation. any symptomatic or asymptomatic af >10s was considered a recurrence. early recurrence was defined as recurrent af >30 days after pv isolation,while late recurrence of af was defined as recurrent af >30 days after. results: at 1 year,57 % had any recurrence of af while 41 % had late recurrence of af. study subjects with one or more pv diameter in the top 10;bsupesup& percentile had trend toward more early recurrent af (hr 1.99,p = 0.053). study subjects with one or more pv csa in the top 10;bsupesup& percentile had more late recurrent af (hr 2.25,p = 0.039) and a trend toward more early recurrent af (hr 1.94,p = 0.064). with multivariate analysis,pv size was not associated with early recurrent af,but late recurrent af was associated with one or more large pv,increased left atrial size,and non-paroxysmal af. study subjects with all three of these risk factors had a 100 % rate of late recurrent af at 1 year,while those with none had a 7 % rate of late recurrent af. conclusions: larger pv size is independently associated with more late recurrent af after pv isolation. determination of pv size prior to pv isolation may predict procedural success. © 2015 hauser et al.