Introduction: Detailed clinical outcomes of cryoballoon ablation of the
left atrial (LA) posterior wall (LAPW) in patients with non-paroxysmal
atrial fibrillation (AF) have not been fully examined. Methods: We
analyzed the outcomes of 191 patients with non-paroxysmal AF, of whom
135 underwent cryoballoon ablation of the LAPW including the LA roof in
addition to pulmonary vein isolation with a cryoballoon. Results:
Complete conduction block at the LA roof was obtained in 97.0%
(131/135) of patients and LAPW was isolated in 85.2% (115/135) of
patients. Over 372 days (range, 182–450 days) of follow-up, atrial
arrhythmia recurrence was observed in 55 (40.7%) patients, and atrial
tachycardia (AT) recurrence accounted for 25.5% of cases. The
prevalence of LA roof cryoballoon ablation tended to be higher in
patients without recurrence than those with (74.3% vs. 61.8%,
respectively; p=0.11), especially those with persistent AF recurrence
(74.5% vs. 46.2%, p=0.01). Multivariate analysis revealed that
cryoballoon ablation of the LA roof was a predictor of freedom from
persistent AF recurrence and that it was not associated with AT
recurrence. Durable LA roof lesions were confirmed in 18 (72.0%) of 25
patients who underwent redo ablation. Conclusion: Cryoballoon ablation
of the LAPW leads to a sufficient acute success rate of complete
conduction block and durable lesions of the LA roof without increasing
the risk of AT recurrence. The prevalence of persistent AF recurrence
decreases after additional cryoballoon ablation of the LAPW in patients
with non-paroxysmal AF.
Differences in Repeating Patterns of Complex Fractionated Left Atrial Electrograms in Longstanding Persistent Atrial Fibrillation as Compared With Paroxysmal Atrial Fibrillation
