Prevalence and clinical outcome of XXXX during superior vena cava isolation and circumferential pulmonary vein antrum isolation using radiofrequency energy.

@entity1 @entity6841 @entity128 @entity358 @entity955
BACKGROUND: @entity128 ( @entity128 ) is recognized as an important complication during @entity955 ablation. This study aimed to investigate the incidence and outcome of @entity128 during superior vena cava isolation (SVCI) and circumferential @entity358 (CPVI) using radiofrequency (RF) energy and the factors associated with its occurrence. METHODS AND RESULTS: Five hundred sixty-seven consecutive @entity1 who underwent SVCI after CPVI without substrate modification who completed a 12-month follow-up were retrospectively analyzed. Point-by-point RF applications were applied with maximum energy settings of 35 W and 30 seconds for the SVCI. In the former 210 @entity1 , sites where pacing captured the @entity6841 were avoided whenever possible; however, the maximum power was 35 W. In the latter 357 @entity1 , RF energy was delivered regardless of @entity6841 capture; however, the power at @entity6841 capture sites was limited to 10 W during continuous diaphragmatic movement monitoring on fluoroscopy. Circumferential @entity358 and SVCI were successfully achieved in all. Twelve @entity1 (2.1%) had @entity128 during SVCI but not during CPVI. @entity128 completely recovered in all @entity1 a median of 8.0 months after the procedure. The prevalence was higher in the former period (3.8% vs 1.1%; P = .03). A multivariate logistic regression analysis revealed that the study period (odds ratio 3.546; 95% CI 1.051-11.965; P = .041) was the sole independent predictor for identifying @entity1 with @entity128 during SVCI. CONCLUSIONS: @entity128 occurred in 2.1% of the @entity1 . All occurred during SVCI but not during contemporary CPVI. Energy titration and continuous diaphragmatic movement monitoring significantly decreased the incidence during SVCI.
