Key result
Cryoballoon ablation as first-line therapy for lone paroxysmal atrial fibrillation achieved 100% acute pulmonary vein isolation and 89% freedom from symptomatic AF recurrence at 14 months.
Why the study?
Does cryoballoon ablation as first-line treatment prevent symptomatic AF recurrence in patients with lone paroxysmal atrial fibrillation?
Cohort (n=18)
Does cryoballoon ablation as first-line treatment prevent symptomatic AF recurrence in patients with lone paroxysmal atrial fibrillation?
Cryoballoon ablation as first-line therapy for lone paroxysmal atrial fibrillation is highly effective, achieving 100% acute pulmonary vein isolation and 89% freedom from symptomatic AF recurrence at 14 months.
Answers are grounded in this paper and cite their sources.
May support first-line cryoballoon ablation in lone paroxysmal AF; hypothesis-generating and requires randomized confirmation.
AIMS: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Nowadays, catheter-based ablative approaches are mainly reserved for drug-refractory patients. However, the value of an ablative therapy as a first-line alternative remains elusive. The aim of our study was to analyse the acute procedural success and clinical outcome of patients with lone paroxysmal AF undergoing cryoballoon ablation (CBA) as first-line treatment. METHODS AND RESULTS: Eighteen individuals (mean age 44 ± 9 years, range 23-61 years, 15 males) with lone paroxysmal AF preferring a catheter-based treatment to drug treatment as first-line therapy were consecutively enrolled in our study. Mean left atrial size was 39 ± 4 mm and mean left ventricular ejection fraction 58 ± 3%. After a mean of 2.4 CBA (range 2-4) applications pulmonary vein (PV) isolation could be demonstrated in 70 (97%) PVs. Additional lesions with a focal ablation catheter were needed to isolate one right inferior pulmonary vein and one left superior pulmonary vein in two different patients. At the end of the procedure, all (100%) PVs were isolated. After a 2-month blanking period, 16 patients (89%) were free of symptomatic AF recurrence at a mean follow-up of 14 ± 9 months and without antiarrhythmic drugs (AADs). CONCLUSION: Cryoballoon ablation in patients with lone paroxysmal AF yields a high acute efficacy rate with a great chance of being free of symptomatic AF recurrence without antiarrhythmic drugs on a mid-term follow-up period, when offered as a first-line treatment.
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Namdar et al. (2011) conducted a cohort in Lone paroxysmal atrial fibrillation (n=18). Cryoballoon ablation was evaluated on Freedom from symptomatic AF recurrence. Cryoballoon ablation as first-line therapy for lone paroxysmal atrial fibrillation achieved 100% acute pulmonary vein isolation and 89% freedom from symptomatic AF recurrence at 14 months.
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