The TTI guided 4 minutes freeze protocol was associated with a significantly higher rate of freedom from arrhythmia recurrence compared to the 3 minutes protocol (66.4% vs 56.1%, P=0.009).
Cohort (n=214)
Does a TTI guided 4 minutes freeze protocol improve freedom from arrhythmia recurrence compared to a 3 minutes freeze protocol in symptomatic AF patients undergoing cryoballoon pulmonary vein isolation?
A 4-minute freeze protocol during cryoballoon pulmonary vein isolation significantly improves freedom from arrhythmia recurrence compared to a 3-minute protocol, particularly in persistent AF, without increasing adverse events.
Tasa de eventos absoluta: 66.4% vs 56.1%
valor p: p=0.009
BACKGROUND: Time-to-isolation (TTI) guided second-generation cryoballoon (CB2) ablation has been shown to be effective for pulmonary vein isolation (PVI). OBJECTIVE: The objective of this paper is to compare the safety and clinical outcome of CB2 PVI using the TTI guided 4 minutes vs 3 minutes freeze protocol. METHODS: This was a propensity-matched study based on an institutional database. Symptomatic atrial fibrillation (AF) patients who underwent CB2 PVI and systematic follow-up were consecutively included. RESULTS: A total of 573 patients were identified, of them 214 (107 matched-pairs) symptomatic AF (paroxysmal AF: 61%, persistent AF: 39%) patients (age: 67.7 ± 11.2 years) were analyzed. The baseline characteristics were comparable between the two groups. Procedural time was significantly longer in the 4 minutes group compared to 3 minutes group (67.2 ± 21.8 vs 55.9 ± 16.9 minutes, P < .0001). During a mean follow-up of 2 years, the 4 minutes group was associated with a significantly higher rate of freedom from arrhythmia recurrence compared with the 3 minutes group (66.4% vs 56.1%, P = .009), which was mainly driven by patients with persistent AF. The multivariate regression showed that the 4 minutes freeze was the independent predictor of freedom from arrhythmia recurrence. During the repeat procedure, the 4 minutes group was associated with a significantly higher rate of durable PVI. There was no difference regarding procedural adverse events between the two groups. CONCLUSION: As compared with the 3 minutes freeze, the TTI guided 4 minutes freeze is associated with a significantly higher rate of arrhythmia-free and durable PVI without compromising the safety profile, patients with persistent AF may benefit from the TTI guided 4 minutes freeze more pronouncedly.
Chen et al. (Thu,) conducted a cohort in Symptomatic atrial fibrillation (n=214). Time-to-isolation guided 4 minutes freeze protocol vs. 3 minutes freeze protocol was evaluated on freedom from arrhythmia recurrence (p=0.009). The TTI guided 4 minutes freeze protocol was associated with a significantly higher rate of freedom from arrhythmia recurrence compared to the 3 minutes protocol (66.4% vs 56.1%, P=0.009).