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Pouched Mitral Isthmus Is Associated with Incomplete Linear Block in Atrial Fibrillation Patients with Mechanical Mitral Valve Replacement
Author(s) -
DENG WENNING,
CHEN KE,
BAI RONG,
ZHANG ZHIJUN,
LI SONGNAN,
WEN ZHAOYING,
ZHANG CHEN,
YU RONGHUI,
LONG DEYONG,
TANG RIBO,
SANG CAIHUA,
LIU NIAN,
GUO XUEYUAN,
WU XIAOYAN,
NIE JUNGANG,
DU XIN,
DONG JIANZENG,
MA CHANGSHENG
Publication year - 2015
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12649
Subject(s) - medicine , atrial fibrillation , cardiology , ablation , mitral valve , catheter ablation , block (permutation group theory) , mitral valve replacement , geometry , mathematics
Pouched Mitral Isthmus and Ablation Block Background Previous studies have described the impact of mitral isthmus (MI) anatomy on the likelihood of achieving MI linear block in patients with native mitral valves (NMV) who underwent atrial fibrillation (AF) ablation. However, none have investigated that issue in AF patients with mechanical mitral valve replacements (MMVR). Methods and Results Twenty‐nine consecutive patients who developed symptomatic persistent AF post‐MMVR and referred for ablation were enrolled. Twenty‐nine patients with NMV who underwent ablation of persistent AF during the same period were matched. With preprocedural cardiac computed tomographic imaging, MI anatomical features of all the participants were analyzed. Pouched MI was observed in 19 (65.5%) MMVR patients versus to 6 (20.7%) controls (P = 0.001). Bidirectional linear block across MI was achieved in 21 (72.4%) MMVR patients and 22 (75.9%) in the controls (P = 0.764). In the multivariable analysis, pouched MI was an independent predictor of incomplete MI block. Conclusions Pouched MI accounts for the majority of AF patients with MMVR and may be associated with incomplete bidirectional linear block of MI.