Abstract：Objective To evaluate the impact of pulmonary vein anatomical variations on the efficacy of cryoablation in patients with persistent atrial fibrillation. Method A retrospective analysis was conducted on the clinical data of 98 patients with persistent atrial fibrillation who had undergone cryoballoon ablation. According to the presence or absence of pulmonary vein variations, they were divided into pulmonary vein variation group (variants group, 21 cases) and non-pulmonary vein variation group (normal group, 77 cases). The procedure time, duration and dose of X-ray exposure, intraoperative complications, procedure success rate of isolation, and each follow-up index were compared between the two groups. Results Compared with the normal group, the ablation procedure time\[(35.1±13.4) min vs. (64.3±17.7) min] and X-ray exposure time [(22.3±5.8) min vs. (33.6±6.0) min] of the variants group were both longer (P<0.01) while the CD value of radiation exposure [(607.1±212.9) mGy vs. (1 018.5±280.8) mGy] significantly increased (P<0.01). In the normal group, the success rate of primary isolation was significantly higher than that in the variants group (75/77 vs. 16/21, P=0.01). However, both groups completed pulmonary vein isolation 100% at the end of procedure. The recurrence rate of the two groups did not vary significantly during one-year follow-up (19/77 vs. 6/21, P=0.726). Conclusion For patients with persistent atrial fibrillation and pulmonary vein variations, the acute-stage and long-term success rates of cryoablation are similar to the rates in the patients without pulmonary vein variation. However, patients with pulmonary vein variations have prolonged procedure time and increased radiation exposure.
