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Long-term Outcomes of Cryoballoon-based Empirical Superior Vena Cava Isolation in Addition to Pulmonary Vein Isolation in Persistent Atrial Fibrillation.
- Source :
-
Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi . Sep2024, Vol. 28 Issue 9, p437-445. 9p. - Publication Year :
- 2024
-
Abstract
- Background: Superior vena cava (SVC) is atrial fibrillation (AF)’s most common non-pulmonary vein (PV) foci. Studies reported conflictory results when SVC isolation (SVCi) was combined with PVi and long-term outcomes were lacking. Therefore, we aimed to evaluate the long-term efficacy and safety of empirical SVCi as an adjunct to cryoballoonbased PV isolation (PVi) in persistent AF ablation. Methods: A total of 40 consecutive persistent AF patients (60.6 ± 8.2 years, 52.5% females) who underwent SVCi in addition to PVi compared with a propensity score matched cohort of 40 persistent AF patients (58.6 ± 8.7 years, 50% female) in whom PVionly was performed. Second-generation cryoballoon (CB2) was used in all procedures. Atrial tachyarrhythmia (ATa) recurrence was defined as the detection of AF, atrial flutter, or atrial tachycardia (≥30 s) after a 3-month blanking period. Results: Pulmonary veins and SVC were successfully isolated in all patients. At a mean of 46.7 ± 7.8 months follow-up, 22 (55%) patients in the PVi-only group, and 27 (67.5%) patients in the PVi+SVCi group were free of ATa after the index procedure (P = .359). Phrenic nerve injury (PNI) was detected in 2 (5%) patients in the PVi-only group (during right PVi) and 2 (5%) patients in the PVi+SVCi group (during SVCi) (P = 1.00). Cox regression analysis revealed that early recurrence was the only predictor of recurrence (hazard ratio 4.88, 95% confidence interval 1.59-14.96; P = .005). Conclusion: Long-term results of our small sample-sized study revealed that CB-based PVi+SVCi was associated with outcomes similar to the PVi-only strategy in patients with persistent AF. Although complication rates were similar between the groups, close follow-up of diaphragmatic movement is crucial to prevent PNI during SVCi. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 21492263
- Volume :
- 28
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi
- Publication Type :
- Academic Journal
- Accession number :
- 179486404
- Full Text :
- https://doi.org/10.14744/AnatolJCardiol.2024.4092