Second-generation cryoballoon ablation maintained sinus rhythm in 67% of persistent AF patients at 10.6 months, with early recurrence strongly predicting late recurrence (HR 3.83; P<0.001).
Observational (n=100)
Does pulmonary vein isolation using second-generation cryoballoon improve freedom from atrial fibrillation in patients with symptomatic persistent atrial fibrillation?
Second-generation cryoballoon ablation for persistent atrial fibrillation achieved 67% freedom from AF at ~10 months, with early recurrence strongly predicting late recurrence.
Effect estimate: HR 3.83 (95% CI 1.91-7.68)
p-value: p=<0.001
BACKGROUND: Data regarding the freedom from atrial fibrillation (AF) in the follow-up of persistent AF patients is limited. The second-generation cryoballoon has better cooling properties compared with first-generation cryoballon. In this study, we aimed to assess the medium-term efficacy of second-generation cryoballoon in patients with persistent AF. METHODS AND RESULTS: A total of 100 patients (63±10 years, 80% male) with symptomatic persistent AF, despite ≥1 antiarrhythmic drug(s), who were scheduled for pulmonary vein isolation using second-generation cryoballoon were enrolled in this study. Follow-up was based on outpatient clinic visits, including Holter ECGs. Recurrence was defined as a symptomatic or documented arrhythmia episode of >30 seconds excluding a 3-month blanking period. As a result, 393 pulmonary veins (7 patients with common ostium) were successfully isolated. Mean procedural and fluoroscopy times were 96.2±21.3 and 19.7±6.7 minutes, respectively. Phrenic nerve palsy occurred in 3% (3/100) of the patients. At a mean follow-up duration of 10.6±6.3 months, 67% of the patients were in sinus rhythm. Stepwise multivariable Cox proportional hazard regression analysis showed that early AF recurrence (hazard ratio 3.83, 95% confidence interval 1.91-7.68, P<0.001) was the only independent predictor for late AF recurrence apart from other clinical and echocardiographic variables. CONCLUSIONS: Our findings indicated that second-generation cryoballoon use is associated with favorable outcomes in patients with persistent AF. Recurrence at blanking period was the only predictor of long-term AF recurrence.
Koektuerk et al. (Wed,) conducted a observational in symptomatic persistent atrial fibrillation (n=100). Second-generation cryoballoon ablation was evaluated on Late atrial fibrillation recurrence / maintenance of sinus rhythm (HR 3.83, 95% CI 1.91-7.68, p=<0.001). Second-generation cryoballoon ablation maintained sinus rhythm in 67% of persistent AF patients at 10.6 months, with early recurrence strongly predicting late recurrence (HR 3.83; P<0.001).