Prevalence and predictive factors of left atrial tachycardia occurring after second-generation cryoballoon ablation of atrial fibrillation

Introduction Assess the prevalence and predictors of Left Atrial Tachycardia (LAT) after cryoballoon ablation of pulmonary veins. Methods and results Patients who underwent catheter ablation of pulmonary veins with a second-generation cryoballoon for symptomatic paroxysmal (151/270, 56%) or persistent (119/270, 44%) atrial fibrillation were entered in a single-centre prospective registry. Patients who experienced post-cryoballoon LAT (pcryo-LAT) were selected on the basis of 12-lead ECG characteristics. Left atrial origin was confirmed during conventional EP study and electroanatomical activation mapping, and patients were treated by RF catheter ablation. Pcryo-LAT was observed in 15 (5.6%) of 270 patients and was attributed to a reentrant mechanism in 11 patients (73%). The other 4 cases of pcryo-LAT were due to focal atrial tachycardia associated with reconnection of one pulmonary vein. In comparison with patients who remained in sinus rhythm, LA area (HR = 1.09; CI 1.01,1.2; p = 0.02), LVEF (HR = 0.94; CI 0.90,0.97; p