Abstract：
BACKGROUND: Prior studies have investigated cardiac anatomy and clinical parameters as predictors for pulmonary vein and non-pulmonary vein triggers.
OBJECTIVE: We aimed to assess the link between the descending aorta to left inferior pulmonary vein (Dao-LIPV) distance and the occurrence of triggers and drivers in atrial fibrillation (AF) ablation procedures.
METHODS: Drug-refractory AF patients who underwent first-time index catheter ablation from January 2010 to December 2019 were retrospectively assembled. The Dao-LIPV distance was measured from preablation pulmonary vein computed tomography. Patients were assigned to groups on the basis of the presence of LIPV triggers or drivers. Multivariate logistic regression was used to identify risk factors.
RESULTS: A total of 886 consecutive patients with drug-refractory AF were studied, and 63 (7.1%) patients were identified to have LIPV triggers or drivers. The Dao-LIPV distance had a better predictive performance (area under the curve, 0.70) compared with persistent AF (area under the curve, 0.57). Multivariate logistic regression analysis showed that Dao-LIPV distance ≤2.5 mm (odds ratio, 3.96; 95% CI, 2.15-7.29; P < .001) and persistent AF (odds ratio, 1.73; 95% CI, 1.02-2.94]; P = .044) were independent predictors for the presence of LIPV triggers or drivers. A risk score model was established to predict the probability of LIPV triggers or drivers with persistent AF (10.2%), Dao-LIPV distance ≤2.5 mm (11.4%), and both (15.0%).
CONCLUSIONS: The proximity of the Dao-LIPV was correlated to the presence of LIPV triggers or drivers. We developed a risk score model indicating that persistent AF and Dao-LIPV distances ≤2.5 mm significantly increase the risk of LIPV triggers or drivers, aiding electrophysiologists in preparing for and performing catheter ablation more effectively.
OBJECTIVE: We aimed to assess the link between the descending aorta to left inferior pulmonary vein (Dao-LIPV) distance and the occurrence of triggers and drivers in atrial fibrillation (AF) ablation procedures.
METHODS: Drug-refractory AF patients who underwent first-time index catheter ablation from January 2010 to December 2019 were retrospectively assembled. The Dao-LIPV distance was measured from preablation pulmonary vein computed tomography. Patients were assigned to groups on the basis of the presence of LIPV triggers or drivers. Multivariate logistic regression was used to identify risk factors.
RESULTS: A total of 886 consecutive patients with drug-refractory AF were studied, and 63 (7.1%) patients were identified to have LIPV triggers or drivers. The Dao-LIPV distance had a better predictive performance (area under the curve, 0.70) compared with persistent AF (area under the curve, 0.57). Multivariate logistic regression analysis showed that Dao-LIPV distance ≤2.5 mm (odds ratio, 3.96; 95% CI, 2.15-7.29; P < .001) and persistent AF (odds ratio, 1.73; 95% CI, 1.02-2.94]; P = .044) were independent predictors for the presence of LIPV triggers or drivers. A risk score model was established to predict the probability of LIPV triggers or drivers with persistent AF (10.2%), Dao-LIPV distance ≤2.5 mm (11.4%), and both (15.0%).
CONCLUSIONS: The proximity of the Dao-LIPV was correlated to the presence of LIPV triggers or drivers. We developed a risk score model indicating that persistent AF and Dao-LIPV distances ≤2.5 mm significantly increase the risk of LIPV triggers or drivers, aiding electrophysiologists in preparing for and performing catheter ablation more effectively.
摘要：
背景：先前的研究已经研究了心脏解剖结构和临床参数作为肺静脉和非肺静脉触发因素的预测因子。
目的：评估降主动脉与左下肺静脉（Dao-LIPV）距离与房颤（AF）消融过程中触发因素和驱动因素的发生之间的联系。
方法：对2010年1月至2019年12月首次接受导管消融的药物难治性房颤患者进行回顾性分析。从消融前肺静脉计算机断层扫描测量Dao-LIPV距离。根据LIPV触发因素和/或驱动因素的存在对患者进行分类。采用多因素logistic回归分析危险因素。
结果：共研究了886例药物难治性房颤患者，63例(7.1%)患者被确定为具有LIPV触发因素和/或驱动因素.与持续性AF(AUC:0.57)相比,Dao-LIPV距离具有更好的预测性能(AUC:0.70)。多因素logistic回归分析显示Dao-LIPV距离≤2.5mm(赔率[OR]3.96[95%CI2.15-7.29],p<0.001)和持续性房颤(OR1.73[95%CI1.02-2.94]，p=0.044）是LIPV触发因素和/或驱动因素存在的独立预测因素。建立了风险评分模型来预测LIPV触发或驱动者持续AF的概率（10.2％），Dao-LIPV距离≤2.5mm(11.4%),两者（15.0%）。
结论：Dao-LIPV的紧密接近与LIPV触发因素或驱动因素的存在相关。我们开发了一个风险评分模型，表明持续AF和Dao-LIPV距离≤2.5mm会显著增加LIPV触发/驱动因素的风险。帮助电生理学家更有效地准备和执行导管消融。
目的：评估降主动脉与左下肺静脉（Dao-LIPV）距离与房颤（AF）消融过程中触发因素和驱动因素的发生之间的联系。
方法：对2010年1月至2019年12月首次接受导管消融的药物难治性房颤患者进行回顾性分析。从消融前肺静脉计算机断层扫描测量Dao-LIPV距离。根据LIPV触发因素和/或驱动因素的存在对患者进行分类。采用多因素logistic回归分析危险因素。
结果：共研究了886例药物难治性房颤患者，63例(7.1%)患者被确定为具有LIPV触发因素和/或驱动因素.与持续性AF(AUC:0.57)相比,Dao-LIPV距离具有更好的预测性能(AUC:0.70)。多因素logistic回归分析显示Dao-LIPV距离≤2.5mm(赔率[OR]3.96[95%CI2.15-7.29],p<0.001)和持续性房颤(OR1.73[95%CI1.02-2.94]，p=0.044）是LIPV触发因素和/或驱动因素存在的独立预测因素。建立了风险评分模型来预测LIPV触发或驱动者持续AF的概率（10.2％），Dao-LIPV距离≤2.5mm(11.4%),两者（15.0%）。
结论：Dao-LIPV的紧密接近与LIPV触发因素或驱动因素的存在相关。我们开发了一个风险评分模型，表明持续AF和Dao-LIPV距离≤2.5mm会显著增加LIPV触发/驱动因素的风险。帮助电生理学家更有效地准备和执行导管消融。
