Key result
Cryoballoon ablation resulted in a 24-month freedom from atrial arrhythmia recurrence of 71.9% in patients with paroxysmal atrial fibrillation compared to 49.3% in those with persistent atrial fibrillation.
Why the study?
Atrial fibrillation is an increasing healthcare burden in Korea, prompting evaluation of long-term efficacy, symptom burden, quality of life, healthcare utilization, and recurrence predictors after cryoballoon ablation.
Does cryoballoon ablation prevent atrial arrhythmia recurrence in Korean patients with atrial fibrillation?
Cohort (n=299)
Yes
Does cryoballoon ablation prevent atrial arrhythmia recurrence in Korean patients with atrial fibrillation?
Cryoballoon ablation is an effective treatment for atrial fibrillation in Korean patients, with paroxysmal AF patients experiencing significantly higher 24-month freedom from arrhythmia recurrence than persistent AF patients.
Answers are grounded in this paper and cite their sources.
Cryoballoon outcomes differ by AF subtype; hypothesis-generating and should not yet change practice.
BACKGROUND AND OBJECTIVES: Atrial fibrillation (AF), the most common atrial arrhythmia (AA), is an increasing healthcare burden in Korea. The objective of this sub-analysis of the Cryo Global Registry was to evaluate long-term efficacy, symptom burden, quality of life (QoL), and healthcare utilization outcomes and factors associated with AA recurrence in Korean patients treated with cryoballoon ablation (CBA). METHODS: Patients were treated and followed up according to local standard-of-care in 3 Korean hospitals. Kaplan-Meier estimates were used in analyzing (1) efficacy defined as freedom from ≥30 second recurrence of AA at 24 months, (2) healthcare utilization, and (3) predictors of 24-month AA recurrence. Patient-reported QoL (using European Quality of Life-5 Dimensions-3 Levels) and predefined AF-related symptoms were assessed at baseline and 24-month follow-up. RESULTS: Efficacy was 71.9% in paroxysmal AF (PAF) and 49.3% in persistent AF (PsAF) patients (p<0.01). A larger left atrial diameter (LAD), an increased time from AF diagnosis to CBA, and PsAF were independent predictors of AA recurrence. The percentage of patients with no AF symptoms significantly increased from baseline (24.5%) to 24-month (89.5%) follow-up (p<0.01). Improvement in QoL from baseline to 24 months was not statistically different between AF cohorts. PAF patients experienced greater freedom from repeat ablations (93.9% vs. 81.4%) and cardiovascular hospitalizations (91.3% vs. 72.5%, p<0.001 for both). CONCLUSIONS: In alignment with global outcomes, CBA is an effective treatment for AF in the Korean population, with patients possessing a large LAD and not receiving ablation soon after diagnosis being the most at risk for AA recurrence. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02752737.
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Ahn et al. (2024) conducted a cohort in Atrial fibrillation (n=299). Cryoballoon ablation vs. Persistent atrial fibrillation (vs paroxysmal atrial fibrillation) was evaluated on Freedom from ≥30 second recurrence of atrial arrhythmia at 24 months (p=<0.01). Cryoballoon ablation resulted in a 24-month freedom from atrial arrhythmia recurrence of 71.9% in patients with paroxysmal atrial fibrillation compared to 49.3% in those with persistent atrial fibrillation.
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