Key result
Cryoballoon PVI yields similar 36-month freedom from AF recurrence in young versus middle-aged patients.
Why the study?
The efficacy and safety of cryoballoon pulmonary vein isolation in young patients with atrial fibrillation compared to middle-aged adults in a real-world setting was not well established.
Does cryoballoon pulmonary vein isolation have similar efficacy and safety in young patients (≤45 years) compared to middle-aged patients (60-65 years) with atrial fibrillation?
Cohort (n=1,318)
Yes
Does cryoballoon pulmonary vein isolation have similar efficacy and safety in young patients (≤45 years) compared to middle-aged patients (60-65 years) with atrial fibrillation?
Absolute Event Rate: 72.4% vs 71.8%
p-value: p=0.550
Cryoballoon pulmonary vein isolation is equally safe and effective for treating atrial fibrillation in young adults (≤45 years) as it is in middle-aged adults (60-65 years).
Comparable cryoballoon PVI efficacy in young versus middle-aged AF; extends cohort data but leaves open randomized confirmation.
BACKGROUND: Atrial fibrillation (AF) is an uncommon arrhythmia in young adults without structural heart disease, and cryoballoon pulmonary vein isolation (CB-PVI) is an important therapeutic strategy for rhythm control in patients with drug-refractory AF. The aim of this analysis was to evaluate efficacy and safety of CB-PVI in a large cohort of young patients in comparison with middle-aged adults in a real-world setting. METHODS: From 2012 to 2020, a total of 3033 patients with AF underwent CB-PVI and were followed prospectively in the framework of the 1STOP Clinical Service project, involving 34 Italian centers. Out of 3033 total 1STOP project subjects, a subgroup of 1318 patients were defined which included a YOUNG group (age ≤ 45 years; n = 368) and a MIDDLE-AGED group (age 60-65 years; n = 950). RESULTS: The acute success rate of PVI did not differ between the two cohorts (99.9 ± 1.3% vs. 99.8 ± 3.2%, p = 0.415). There was no difference in procedural characteristics, and periprocedural complication rates were similar among the two cohort (1.9% vs. 2.3%, p = 0.646). The 12-month freedom from AF recurrence was 88.9% (95% confidence interval [CI]: 84.7-92.0) in the YOUNG cohort and 85.6% (95% CI: 82.9-88.0) in the MIDDLE-AGED group. At 36-month follow-up, freedom from AF recurrence was 72.4% (65.5%-78.2%) and 71.8% (67.7%-75.6%), respectively with no significant difference among groups (p = 0.550). CONCLUSION: CB-PVI had similar efficacy and safety in YOUNG and MIDDLE-AGED patients. Younger age did not affect acute procedural results, complication rate, or AF recurrence after a single procedure.
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Bertaglia et al. (2022) conducted a cohort in Atrial fibrillation (n=1,318). Young age (≤ 45 years) vs. Middle-aged (60-65 years) was evaluated on Freedom from AF recurrence at 36 months (p=0.550). Cryoballoon pulmonary vein isolation had similar 36-month freedom from atrial fibrillation recurrence in young (≤45 years) and middle-aged (60-65 years) patients (72.4% vs 71.8%; p=0.550).
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