Why the study?
Time-to-isolation guided second-generation cryoballoon ablation is effective for pulmonary vein isolation, but the safety and clinical outcomes comparing 4-minute vs 3-minute freeze protocols needed comparison.
Does a TTI guided 4 minutes freeze protocol improve freedom from arrhythmia recurrence compared to a 3 minutes freeze protocol in symptomatic AF patients undergoing cryoballoon pulmonary vein isolation?
Population
214 symptomatic AF patients undergoing CB2 PVI
Comparison
TTI-guided 4 minutes vs 3 minutes freeze protocol
Design
Propensity-matched study based on an institutional database
Follow-up
Mean follow-up of 2 years
Key result
The TTI guided 4 minutes freeze protocol was associated with a significantly higher rate of freedom from arrhythmia recurrence compared to the 3 minutes protocol (66.4% vs 56.1%, P=0.009).
Authors
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May support TTI-guided 4-min freezes in cryoballoon PVI; leaves open need for RCT confirmation.
Cohort (n=214)
Does a TTI guided 4 minutes freeze protocol improve freedom from arrhythmia recurrence compared to a 3 minutes freeze protocol in symptomatic AF patients undergoing cryoballoon pulmonary vein isolation?
Absolute Event Rate: 66.4% vs 56.1%
p-value: p=0.009
A 4-minute freeze protocol during cryoballoon pulmonary vein isolation significantly improves freedom from arrhythmia recurrence compared to a 3-minute protocol, particularly in persistent AF, without increasing adverse events.
Chen et al. (2020) conducted a cohort in Symptomatic atrial fibrillation (n=214). Time-to-isolation guided 4 minutes freeze protocol vs. 3 minutes freeze protocol was evaluated on freedom from arrhythmia recurrence (p=0.009). The TTI guided 4 minutes freeze protocol was associated with a significantly higher rate of freedom from arrhythmia recurrence compared to the 3 minutes protocol (66.4% vs 56.1%, P=0.009).