TABLE 4.
Ablation strategy and procedure outcome.
| Study | Ablation strategy | Ablation targets in PLSVC |
Rate of PLSVC ablation (PLSVC-a) and isolation (PLSVC-i) |
Complications | Follow-up |
Recurrence | |
| Period (m) | Time points and methods | ||||||
| Hsu et al. (11) | PVI + PLSVC | CS-PLSVC Cns LA-PLSVC Cns |
PLSVC-a in all 5 pts, PLSVC-i in 4/5 pts |
None | 15 ± 10 | At regular intervals (unspecified); 12-lead and ambulatory ECG |
1 AF (failed PLSVC-i), 1 LA flutter |
| Elayi et al. (4) | PVI + PLSVC | CS-PLSVC Cns LA-PLSVC Cns |
PLSVC-i in all 6 pts | None | 13 ± 7 | rhythm transmitters; 12-lead ECG, and 48 h Holter monitoring at 3, 6, and 12 months after ablation; |
none |
| Liu et al. (12) | PVI + PLSVC | PLSVC potentials | PLSVC-i in all 4 pts | None | 18 ± 7 | Clinic visit with symptom recurrence; 24 h Holter monitor at 6–9 months after ablation procedure |
3/4 pts in SR after a median of 2 (2–3) procedures |
| Hwang et al. (17) | NR | LA-PLSVC Cns | PLSVC-a in all 26 pts, PLSVC-i: NR |
NR | 15.6 ± 5.5 | Not specified | 18/26 pts in SR |
| Wissner et al. (5) | PVI, conditional CFAE, conditional PLSVC |
High-frequency signals at mid-to proximal PLSVC |
PLSVC-a in 3/7 pts, 7/14 procedures; PLSVC-i: NR |
1 LPN injury, 1 cardiac tamponade, 1 ischemic stroke |
23.8 ± 11.6 | 12-lead ECG and 24h Holter monitoring 1, 3, and 6 m after the procedure and at 6m intervals; event recorder |
5/7 pts in SR after a median of 2 (1–4) procedures |
| Minami et al. (16) | PVI, conditional PLSVC |
NR | PLSVC-a PLSVC-i in 5/9 pts |
NR | 16.0 ± 9.8 | Not specified | 7/9 pts in SR |
| Kim et al. (6) | PAF: PVI + trigger + conditional PLSVC; PsAF: PVI + conditional linear/CFAE/ PLSVC |
Circumferential ablation at mid-PLSVC, LA-PLSVC Cns, High-frequency signals |
PLSVC-a in 26/32 pts; PLSVC-i: NR |
3 cardiac tamponades | 74.0 ± 40.2 | 12-lead ECG at 1, 3, and 6 m after the procedure and at 6m intervals thereafter; event recorder | 22/32 pts in SR |
| Santoro et al. (13) | PVI; conditional PLSVC |
NR | PLSVC-a in 3/8 pts, PLSVC-i in 2/8 pts | 2 RPN injury | 332 days | 12-lead ECG and 24h Holter monitoring 1, 3, and 6 m after the procedure and at 6m intervals; CIED interrogation; telephone interviews in cases of recurrence symptoms |
63.5% pts in SR |
| Turagam et al. (14) | PVI ± focal/lines; CFAE in all PsAF |
Mid-PLSVC; High-frequency signals; Proximal CS; Endo-LA at operators’ discretion |
PLSVC-a in 28 pts, PLSVC-i in 27 pts |
1 minor pericardial effusion; 3 groin hematomas |
1 year | 12-lead ECG and 24h Holter monitoring 1, 3, 6, and 12 m after the procedure | 75% pts in SR |
| Vaidya et al. (18) | NR | NR | PLSVC-a in 9/20 pts, PLSVC-i in 7/20 pts |
2 pericardial effusions | 1 year | Not specified | 65% pts in SR |
| Kantenwein et al. (15) | PVI ± CFAE/line/ PLSVC |
NR | PLSVC-a in 6/15 pts, 13/27 procedures, PLSVC-i: NR |
1 atrial septum dissection | NR | Not specified | 2nd ablation needed in 9 pts 3rd ablation needed in 3 pts |
Abbreviations same as Table 1. CIED, cardiac implanted electronic device; LPN, left phrenic nerve; NR, not-reported; RPN, right phrenic nerve; SR, sinus rhythm.