Is the Time of Atrial Fibrillation Recurrence After Duty-Cycled Radiofrequency Ablation Affected by the Pattern of Pulmonary Vein Reconnections?
Bibliographic record
Abstract
BACKGROUND: Pulmonary vein isolation (PVI) with multielectrode duty-cycled radiofrequency (PVAC) has been shown to be effective in the treatment of atrial fibrillation (AF). We describe pulmonary vein (PV) reconnection at repeat ablation in patients with AF recurrence after PVAC PVI and analyze the correlation between the time of AF recurrence and the observed PV reconnection patterns. METHODS: Eighty-five patients undergoing a redo PVI for recurrent AF 9.2 ± 3.8 months after an initial PVAC PVI procedure was retrospectively enrolled. RESULTS: A total of 93% had PV reconnections with a mean of 2.97 ± 1.2 reconnected PVs/patients and 75% of formerly isolated PVs were found reconnected. The highest reconnection rates (94%) were observed for left common trunks (CTs). A total of 33% patients had three and four reconnected PVs, respectively, while 7% were without PV reconnection. There was a moderate but significant negative correlation between the time of AF recurrences and the extending of PV reconnections at redo PVI for patients with proven PV reconnection (r = -0.32, P = 0.005), whereas five out of six patients without PV reconnection had recurrences within the first 9 months after PVI. CONCLUSIONS: At redo ablation most patients with recurrence of AF after PVAC PVI had PV reconnection(s). Patients with PV reconnection(s) showed a moderate negative correlation between the number of reconnected PVs and the time of AF recurrence with more extensive PV reconnections resulting in earlier PV recurrences after the blanking period. Patients without PV reconnection experienced early AF recurrences, indicating non-PV triggers contribute to AF recurrences in these patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".