Cryoablation of para-Hisian and mid-septal accessory pathways achieved an 81% long-term success rate at 150 months, significantly reducing symptoms (12% vs 96%) and antiarrhythmic drug use.
Cohort (n=26)
Does a specific stepwise cryoablation protocol improve long-term outcomes in patients with para-Hisian and mid-septal accessory pathways?
A specific stepwise cryoablation protocol for para-Hisian and mid-septal accessory pathways demonstrates remarkable long-term safety and efficacy, with significant symptom reduction even in patients with acute procedural failure.
BACKGROUND: Although cryoablation (CA) of septally located accessory pathways (APs) is an established treatment for Wolff-Parkinson-White Syndrome, its major limitation is the lack of data regarding long-term follow-up (FU). The present study sought to investigate long-term outcomes of a specific CA protocol targeting para-Hisian (P-H) and mid-septal (M-S) APs. METHODS: Twenty-six patients who previously underwent CA of PH or MS APs from 2004 to 2014, were prospectively considered to receive a FU during 2021. All subjects received an outpatient control visit, performing an exercise stress test and a 24-h ECG Holter monitoring. RESULTS: Acute success was achieved in 22 patients (85%). One case of recurrence was reported at short-term FU. Long-term FU, performed after a mean time of 150±37 months, did not show ventricular preexcitation recurrences, with a success rate of 81%, and without late adverse events. Symptoms reduction (12% vs. 96%, P<.001) and lower rates of antiarrhythmic drug use (12% vs. 62%, P<.001) were observed at long term-FU with respect to baseline. This clinical outcome was detected also among patients who underwent unsuccessful CA at baseline. CONCLUSIONS: Our CA protocol confirmed remarkable safety and efficacy throughout a long-term FU. Significant clinical improvement in terms of antiarrhythmic therapy discontinuation and symptoms reduction was also shown among patients who experienced acute failure of CA.
Mitacchione et al. (Fri,) conducted a cohort in Wolff-Parkinson-White Syndrome with para-Hisian and mid-septal accessory pathways (n=26). Stepwise cryoablation protocol vs. Baseline was evaluated on Long-term success (absence of ventricular preexcitation recurrences). Cryoablation of para-Hisian and mid-septal accessory pathways achieved an 81% long-term success rate at 150 months, significantly reducing symptoms (12% vs 96%) and antiarrhythmic drug use.
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