Key result
Linear ablation with a cryoballoon resulted in durable conduction block in 74.5% of left atrial posterior wall roof lines and 45.7% of bottom lines among patients undergoing re-do ablation.
Why the study?
Although PVI and linear ablation of the LAPW can be achieved with a cryoballoon, the long-term durability of these linear lesions remained to be investigated.
Does left atrial linear ablation with a cryoballoon create durable lesions in patients with persistent atrial fibrillation?
Cohort (n=290)
Does left atrial linear ablation with a cryoballoon create durable lesions in patients with persistent atrial fibrillation?
Cryoballoon ablation for the left atrial posterior wall roof line creates durable lesions, particularly when the roof line is relatively short.
May support cryoballoon roof lines in re-do ablation; hypothesis-generating for bottom lines given variable durability in this cohort.
INTRODUCTION: Pulmonary vein isolation (PVI) and linear ablation with a roof line and bottom line on the left atrial (LA) posterior wall (LAPW) can be achieved with a cryoballoon (CB). This study sought to investigate the long-term durability of these linear lesions. METHODS AND RESULTS: Among 290 persistent patients with atrial fibrillation (AF) who had undergone linear ablation with a CB on the roof and bottom line of the LAPW in addition to the PVI, we analyzed those patients who underwent a re-do AF ablation. Arrhythmia recurrence was confirmed in 70 (24%) out of 290 patients, and 47 (16%) patients underwent re-do sessions. At the beginning of the re-do ablation, we examined the reconnection sites of the linear lesions on the LAPW and PVI. Maintenance of the conduction block on the LAPW roof and bottom lines was observed in 35 out of 47 patients (74.5%), and 16 out of 35 patients (45.7%), respectively. The length of the roof line was significantly shorter in patients with preservation of the conduction block on the LAPW roof than in those without (36.2 ± 6.5 mm vs 41.6 ± 4.7 mm, P = .02). CONCLUSION: Durable lesions could be obtained after linear ablation with the CB for the LAPW roof line, especially in those with a relatively short LAPW roof line. However, patients requiring touch-up ablation with radiofrequency were included, and that was associated with a potential financial implication.
No takes yet. Share an insight, caveat, or question.
Shigeta et al. (2020) conducted a cohort in Persistent atrial fibrillation (n=290). Linear ablation with a cryoballoon was evaluated on Maintenance of the conduction block on the left atrial posterior wall roof and bottom lines. Linear ablation with a cryoballoon resulted in durable conduction block in 74.5% of left atrial posterior wall roof lines and 45.7% of bottom lines among patients undergoing re-do ablation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: