Length of the Mitral Isthmus But Not Anatomical Location of Ablation Line Predicts Bidirectional Mitral Isthmus Block in @entity1 Undergoing Catheter Ablation of Persistent XXXX : A Randomized Controlled Trial.

@entity1 @entity162 @entity339 @entity955 @entity616
INTRODUCTION: @entity339 ( @entity339 ) ablation is an effective option in @entity1 undergoing ablation for persistent @entity955 ( @entity955 ). Achieving bidirectional conduction block across the @entity339 is challenging, and predictors of @entity339 ablation success remain incompletely understood. We sought to determine the impact of anatomical location of the ablation line on the efficacy of @entity339 ablation. METHODS AND RESULTS: A total of 40 consecutive @entity1 (87% male; 54    10 years) undergoing stepwise @entity955 ablation were included. @entity339 ablation was performed in sinus rhythm. @entity339 ablation was performed from the left inferior PV to either the posterior (group 1) or the anterolateral (group 2) mitral annulus depending on randomization. The length of the @entity339 line (measured with the 3D mapping system) and the amplitude of the EGMs at 3 positions on the @entity339 were measured in each @entity1 . @entity616 was achieved in 14/19 (74%) @entity1 in group 1 and 15/21 (71%) @entity1 in group 2 (P = NS). Total @entity339 radiofrequency time (18    7  min vs. 17    8 min; P = NS) was similar between groups. @entity1 with incomplete @entity616 had a longer @entity339 length (34    6 mm vs. 24    5 mm; P < 0.001), a @entity162 along the @entity339 (1.75    0.74  mV vs. 1.05    0.69 mV; P < 0.01), and a longer history of continuous @entity955 (19    17 months vs. 10    10 months; P < 0.05). In multivariate analysis, decreased length of the @entity339 was an independent predictor of successful @entity616 (OR 1.5; 95% CI 1.1-2.1; P < 0.05). CONCLUSIONS: Increased length but not anatomical location of the @entity339 predicts failure to achieve bidirectional @entity616 during ablation of persistent @entity955 .
