Second-generation cryoballoon ablation achieved freedom from atrial tachyarrhythmias in 81.9% of patients with drug-refractory atrial fibrillation at 12 months.
Cohort (n=393)
No
What is the 1-year efficacy of pulmonary vein isolation using the second-generation cryoballoon in patients with drug-refractory atrial fibrillation?
Second-generation cryoballoon ablation provides high rates of freedom from atrial tachyarrhythmias at 1 year, particularly in patients with paroxysmal atrial fibrillation.
AIM: The second-generation cryoballoon (CB-Adv) is effective in achieving pulmonary vein isolation (PVI) with encouraging results. In this study, we assessed the single-procedure outcome on a 1-year follow-up period in a large sample of patients having undergone PVI for drug-resistant atrial fibrillation (AF) using the CB-Adv. METHODS AND RESULTS: A total of 393 patients (122 female, 31%; mean age 57.7 ± 12.9 years) with drug-refractory AF undergoing PVI using the novel CB-Adv were enrolled. Follow-up was based on outpatient clinic visits including Holter electrocardiograms. Recurrence of atrial tachyarrhythmias (ATas) was defined as a symptomatic or documented episode >30 s. A total of 1572 pulmonary veins (PVs) were identified and successfully isolated with 1.2 ± 0.3 mean freezes. Mean procedure and fluoroscopy times were 87.1 ± 38.2 and 14.9 ± 6.1 min, respectively. At a mean follow-up of 12 months, freedom from ATas after a single procedure was achieved in 85.8% of patients with paroxysmal atrial fibrillation and in 61.3% of patients with persistent AF (persAF). Similar success rates were observed between bonus freeze and single freeze strategies, 82.5 and 81.8%, respectively (P = 0.9). Multivariate analysis demonstrated that persAF (P = 0.04) and relapses during blanking period (BP) (P < 0.0001) were independent predictors of ATas recurrences. CONCLUSION: Freedom from any ATa can be achieved in 81.9% of patients after a single CB-Adv procedure in a large cohort of patients. A bonus freeze does not influence the clinical outcome, and reducing the duration of the cryoapplication to 3 min offers excellent results. Persistent AF and arrhythmia recurrence during the BP are strong predictors of AF recurrence.
Irfan et al. (2015) conducted a cohort in drug-refractory atrial fibrillation (n=393). Second-generation cryoballoon (CB-Adv) ablation was evaluated on Freedom from atrial tachyarrhythmias (ATas) after a single procedure. Second-generation cryoballoon ablation achieved freedom from atrial tachyarrhythmias in 81.9% of patients with drug-refractory atrial fibrillation at 12 months.