Key result
A single cryoballoon ablation procedure achieved a 5-year freedom from atrial fibrillation recurrence rate of 59.4%, with persistent atrial fibrillation identified as an independent predictor of recurrence (HR 1.72).
Why the study?
Data on 5-year outcomes and predictors of AF recurrence following cryoballoon ablation in a Chinese population remain scarce.
Does a single first-generation cryoballoon ablation procedure prevent atrial fibrillation recurrence over 5 years in a Chinese population with paroxysmal or persistent AF?
Cohort (n=256)
No
Does a single first-generation cryoballoon ablation procedure prevent atrial fibrillation recurrence over 5 years in a Chinese population with paroxysmal or persistent AF?
In a Chinese population, a single cryoballoon ablation procedure for atrial fibrillation achieved a 59.4% success rate at 5 years, with persistent AF identified as an independent predictor of recurrence.
Supports moderate 5-year durability of single cryoballoon PVI in Chinese AF; leaves open need for RCTs to guide practice.
Background The 5-year outcomes and predictors of atrial fibrillation (AF) recurrence following cryoballoon (CB) ablation in Chinese population remain scarce. Our aim was to report 5-year outcomes and predictors of AF recurrence following a single CB ablation procedure in a Chinese population. Methods From December 2013 to August 2016, we included 256 consecutive patients (mean age: 58 ± 10.9 years old; female: 41.0%) with paroxysmal or persistent AF successfully underwent first-generation CB ablation at Fuwai hospital in this prospective study. All patients were followed at least 5 years or when there was recurrent AF. Independent predictors of AF recurrence were determined by Cox proportional hazards regression analysis. Results The 5-year success rate after pulmonary vein isolation (PVI) by a single procedure was 59.4%. The recurrence rate was the highest (14.5%) within the first year after the index procedure, and then stabilized. Patients with paroxysmal AF had a higher incidence of freedom from AF recurrence than patients with persistent AF (63.2% vs. 36.4%, log-rank P < 0.01). The overall incidence of complications related to CB ablation was 7.8%. Phrenic nerve injury (PNI) was the most common complication, with an incidence of 3.5%, and patients with PNI were recovered within the 1-year follow-up. Only persistent AF (HR 1.72, 95%CI 1.028–2.854, P < 0.05) was significantly and independently associated with an increased risk of AF recurrence after adjusting for other factors. Conclusion Pulmonary vein isolation using CB ablation was safe and effective with an acceptable complication and 5-year success rate in a Chinese population with AF, and persistent AF was the independent predictor for 5-year AF recurrence after a single CB ablation procedure.
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Chen et al. (2022) conducted a cohort in Atrial fibrillation (n=256). Cryoballoon ablation was evaluated on 5-year freedom from atrial fibrillation recurrence. A single cryoballoon ablation procedure achieved a 5-year freedom from atrial fibrillation recurrence rate of 59.4%, with persistent atrial fibrillation identified as an independent predictor of recurrence (HR 1.72).
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