Abstract
Background
Currently available second-generation cryoballoon (CB2) is accepted as an effective and safe tool for pulmonary vein isolation (PVI). Although much more data exists about 1-year outcomes of CB2 ablation, data on long-term outcomes are scarce. Objective: We aimed to assess the long-term outcomes of PVI using CB2 in a large-scale symptomatic AF population at our tertiary referral center.
Methods
In this non-randomized prospective observational study, a total of 486 patients with paroxysmal (71%) or persistent (29%) AF who underwent index PVI using CB2 at our hospital between January 2013 and June 2017 were enrolled. Atrial tachyarrhythmia (ATa) free survival was defined as absence of AF, atrial flutter or atrial tachycardia recurrence >30 s following 3-months blanking period. Predictors of recurrence were evaluated by univariate and multivariate Cox proportional hazards regression models.
Results
Acute procedural success rate was 99.8% (1898/1902 PVs). Mean procedural and fluoroscopy time were 64.9±9.2 and 12.1±2.6, respectively. At median 39 (IQR: 26–56) months follow-up, ATa free survival was 78.6% after a single procedure (280/345 [81.2%] for paroxysmal AF vs 102/141 [72.3%] for persistent AF, p=0.019) and 84.4% after a mean 1.48±0.42 ablations.Cox regression analysis showed that left atrium diameter, duration of AF history and early ATa recurrence were found as the independent predictors of late recurrence. PNP was observed in 17 (3.5%) patients.
Figure 1
Conclusions
Second-generation CB based PVI is effective to maintain sinus rhythm in a significant proportion of paroxysmal and early persistent AF patients with an acceptable complication rates at long-term follow-up.
Correction to: Arrhythmia-free survival and pulmonary vein reconnection patterns after second-generation cryoballoon and contact-force radiofrequency pulmonary vein isolation
