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One-year follow-up after second-generation cryoballoon ablation for atrial fibrillation in a large cohort of patients: a single-centre experience.
- Source :
-
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2016 Jul; Vol. 18 (7), pp. 987-93. Date of Electronic Publication: 2015 Dec 23. - Publication Year :
- 2016
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Abstract
- Aim: The second-generation cryoballoon (CB-Adv) is effective in achieving pulmonary vein isolation (PVI) with encouraging results. In this study, we assessed the single-procedure outcome on a 1-year follow-up period in a large sample of patients having undergone PVI for drug-resistant atrial fibrillation (AF) using the CB-Adv.<br />Methods and Results: A total of 393 patients (122 female, 31%; mean age 57.7 ± 12.9 years) with drug-refractory AF undergoing PVI using the novel CB-Adv were enrolled. Follow-up was based on outpatient clinic visits including Holter electrocardiograms. Recurrence of atrial tachyarrhythmias (ATas) was defined as a symptomatic or documented episode >30 s. A total of 1572 pulmonary veins (PVs) were identified and successfully isolated with 1.2 ± 0.3 mean freezes. Mean procedure and fluoroscopy times were 87.1 ± 38.2 and 14.9 ± 6.1 min, respectively. At a mean follow-up of 12 months, freedom from ATas after a single procedure was achieved in 85.8% of patients with paroxysmal atrial fibrillation and in 61.3% of patients with persistent AF (persAF). Similar success rates were observed between bonus freeze and single freeze strategies, 82.5 and 81.8%, respectively (P = 0.9). Multivariate analysis demonstrated that persAF (P = 0.04) and relapses during blanking period (BP) (P < 0.0001) were independent predictors of ATas recurrences.<br />Conclusion: Freedom from any ATa can be achieved in 81.9% of patients after a single CB-Adv procedure in a large cohort of patients. A bonus freeze does not influence the clinical outcome, and reducing the duration of the cryoapplication to 3 min offers excellent results. Persistent AF and arrhythmia recurrence during the BP are strong predictors of AF recurrence.<br /> (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)
- Subjects :
- Aged
Belgium
Catheter Ablation adverse effects
Cryosurgery adverse effects
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Heart Atria physiopathology
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Postoperative Complications epidemiology
Proportional Hazards Models
Pulmonary Veins surgery
Recurrence
Retrospective Studies
Time Factors
Treatment Outcome
Atrial Fibrillation surgery
Catheter Ablation methods
Cryosurgery methods
Tachycardia epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2092
- Volume :
- 18
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 26705562
- Full Text :
- https://doi.org/10.1093/europace/euv365