What does this research mean for the field?

Dormant pulmonary vein conduction is provoked significantly less frequently in veins isolated by second-generation cryoballoons (0%) than in those requiring focal cryoablation (50%). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

June 15, 2015Journal of Cardiovascular Electrophysiology

Adenosine Triphosphate Test After Cryothermal Pulmonary Vein Isolation: Creating Contiguous Lesions Is Essential for Eliminating Dormant Conduction

Q: What are the key findings of this study?

Dormant pulmonary vein conduction was provoked in 0% of veins isolated by cryoballoons compared to 50.0% of veins isolated by focal cryoablation (P < 0.0001).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: paroxysmal atrial fibrillation (n=54). Intervention: Cryoballoon ablation vs. Focal cryoablation. Primary outcome: transient ATP-provoked reconnections (dormant pulmonary vein conduction) (p=< 0.0001).

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Key result

Cryoballoon ablation eliminates dormant PV conduction vs. a 50% rate with focal cryoablation.

P<0.0001
n=54

Why the study?

The incidence of latent pulmonary vein conduction after cryothermal pulmonary vein isolation was not well characterized.

Comparison

PVs isolated by cryoballoon vs PVs isolated by focal cryothermal ablation

Design

Prospective cohort study

Follow-up

Mean 7.7 months

Authors

SMShinsuke MiyazakiElectrophysiology HTHiroshi TaniguchiFujita Health University HHHitoshi HachiyaElectrophysiology

Discussion

Member takes

Implication

ATP testing after cryoballoon PVI may detect latent conduction; leaves open whether routine use improves outcomes in paroxysmal AF.

Study Design

Type

Cohort (n=54)

PICO

Population

54 consecutive patients with paroxysmal atrial fibrillation undergoing cryothermal pulmonary vein isolation, followed for a mean of 7.7 months.

Exposure / Comparator

Cryoballoon ablation vs Focal cryoablation

Primary Outcome

transient ATP-provoked reconnections (dormant pulmonary vein conduction), p=< 0.0001

Main Result

Absolute Event Rate: 0% vs 50%

p-value: p=< 0.0001

Cite This Study

Miyazaki et al. (2015) conducted a cohort in paroxysmal atrial fibrillation (n=54). Cryoballoon ablation vs. Focal cryoablation was evaluated on transient ATP-provoked reconnections (dormant pulmonary vein conduction) (p=< 0.0001). Dormant pulmonary vein conduction was provoked in 0% of veins isolated by cryoballoons compared to 50.0% of veins isolated by focal cryoablation (P < 0.0001).

synapsesocial.com/papers/6ac47990a168ed2e374ca3a9 https://doi.org/10.1111/jce.12726

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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Adenosine Triphosphate Test After Cryothermal Pulmonary Vein Isolation: Creating Contiguous Lesions Is Essential for Eliminating Dormant Conduction

Discussion

Member takes

Implication

Study Design

PICO

Main Result

Cite This Study

Topics

Adenosine Triphosphate Test After Cryothermal Pulmonary Vein Isolation: Creating Contiguous Lesions Is Essential for Eliminating Dormant Conduction

Discussion

Member takes

Implication

Study Design

PICO

Main Result

Cite This Study

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Topics

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