Key result
Cryoballoon posterior wall isolation linked to ~32% greater 12-month freedom from atrial tachyarrhythmias vs radiofrequency.
Why the study?
To evaluate clinical outcomes over a 12-month follow-up in patients undergoing repeat procedures for recurrent persistent atrial fibrillation following an index cryoballoon pulmonary vein isolation ablation.
Does left atrial posterior wall isolation with cryoballoon improve freedom from atrial tachyarrhythmias compared to linear ablation with radiofrequency in patients undergoing repeat procedures for recurrent persistent atrial fibrillation?
Cohort (n=100)
No
Does left atrial posterior wall isolation with cryoballoon improve freedom from atrial tachyarrhythmias compared to linear ablation with radiofrequency in patients undergoing repeat procedures for recurrent persistent atrial fibrillation?
Absolute Event Rate: 82% vs 62%
p-value: p=0.03
Left atrial posterior wall isolation using cryoballoon significantly improves freedom from atrial arrhythmias compared to radiofrequency linear ablation in patients undergoing redo procedures for persistent atrial fibrillation.
Cryoballoon LAPWI was associated with higher ATA freedom in redo persAF; hypothesis-generating and requires randomized confirmation before practice change.
Aims To evaluate the clinical outcome in patients undergoing repeat procedures for recurrent persistent atrial fibrillation following an index cryoballoon (CB‐A) pulmonary vein isolation ablation on a mid‐term follow‐up of 12 months. Methods In this propensity score‐matched comparison, 50 patients undergoing left atrial posterior wall isolation (LAPWI) with the CB‐A were matched to 50 patients treated with additional linear ablation using radiofrequency catheter ablation (RFCA). Results Meantime to repeat the procedure was 9.74 ± 4.36 months. At 12 months follow‐up freedom from atrial tachyarrhythmias (ATas) was achieved in 82% of patients in the LAPWI group and in 62% of patients in the linear ablation group ( P = .03). Regression analysis demonstrated that relapses during the blanking period and LA dimensions were independent predictors of ATas recurrences following the repeat procedure. Conclusion LAPWI using CB‐A is associated with a significantly higher freedom from atrial arrhythmias when compared with the RFCA mediated left atrial linear lesions on a mid‐term follow‐up of 12 months in patients with persAF undergoing a redo procedure.
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Bisignani et al. (2021) conducted a cohort in Recurrent persistent atrial fibrillation (n=100). Left atrial posterior wall isolation (LAPWI) with cryoballoon vs. Additional linear ablation (roof and mitral line) using radiofrequency catheter ablation was evaluated on Freedom from atrial tachyarrhythmias (episodes >30 seconds after a 90-day blanking period) (p=0.03). Left atrial posterior wall isolation with a cryoballoon increased 12-month freedom from atrial tachyarrhythmias compared to radiofrequency linear ablation (82% vs 62%, P=0.03) in recurrent persAF.
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