Key result
Longer elapsed time from persistent atrial fibrillation diagnosis to cryoballoon ablation independently predicted atrial tachyarrhythmia recurrence (HR 1.07; 95% CI 1.03-1.11; p=0.002).
Why the study?
Freedom from recurrences of atrial tachyarrhythmia remains suboptimal following pulmonary vein isolation in persistent atrial fibrillation, prompting evaluation of predictors of ablation success.
What are the predictors of atrial tachyarrhythmia recurrence after cryoballoon ablation in patients with persistent atrial fibrillation?
Observational (n=882)
Yes
What are the predictors of atrial tachyarrhythmia recurrence after cryoballoon ablation in patients with persistent atrial fibrillation?
Hazard Ratio: 1.07 (95% CI 1.03–1.11)
p-value: p=0.002
Earlier treatment with cryoballoon ablation and fewer previously failed antiarrhythmic drugs predict better freedom from atrial tachyarrhythmia recurrence in patients with persistent atrial fibrillation.
Earlier ablation may lower recurrence risk in persistent AF; leaves open causal benefit in randomized trials.
INTRODUCTION: Freedom from recurrences of atrial tachyarrhythmia (ATA) is suboptimal after pulmonary vein isolation (PVI) in patients with persistent atrial fibrillation (PsAF). This sub-analysis from the Cryo Global Registry sought to investigate predictors of ablation success after PVI using cryoballoon ablation (CBA) for PsAF. METHODS AND RESULTS: ATA recurrence was defined as ≥ 30 s recurrence of atrial fibrillation, atrial flutter or atrial tachycardia after a 90-day blanking period and through 12-months. Univariate and multivariable Cox regression analysis (with ATA recurrence as an endpoint) was performed to identify CBA responders. PsAF patients (N = 882) were on average 63.9 ± 11.3 years old (69.2% male), and freedom from ATA recurrence was 79.7% (76.8%-82.2%). Longer elapsed time from PsAF diagnosis to ablation (hazard ratio [HR] 1.07 (95% confidence interval [CI]: 1.03-1.11); p = 0.002) and a larger number of previously failed antiarrhythmic drugs (HR 1.39 (95% CI: 1.13-1.70); p < 0.002) were shown to be independent predictors of ATA recurrence in a multivariate model which included 703 evaluated patients. CONCLUSION: These real-world results provide important insights to guide referral of PsAF patients, including the benefits of earlier treatment via CBA.
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Chun et al. (2025) conducted an observational in Persistent atrial fibrillation (PsAF) (n=882). Longer elapsed time from PsAF diagnosis to ablation was evaluated on Atrial tachyarrhythmia (ATA) recurrence (≥ 30 s recurrence of AF, atrial flutter or atrial tachycardia after a 90-day blanking period and through 12-months) (HR 1.07, 95% CI 1.03-1.11, p=0.002). Longer elapsed time from persistent atrial fibrillation diagnosis to cryoballoon ablation independently predicted atrial tachyarrhythmia recurrence (HR 1.07; 95% CI 1.03-1.11; p=0.002).
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