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May 19, 2015EP Europace82 citationsOpen Access

One-year clinical outcome after pulmonary vein isolation in persistent atrial fibrillation using the second-generation 28 mm cryoballoon: a retrospective analysis

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CLChristine LemešEWErik WißnerTLTina Lin

Key Result

Pulmonary vein isolation using the second-generation 28 mm cryoballoon in patients with persistent atrial fibrillation was associated with a 69% 1-year clinical success rate.

Study Design

Type

Observational (n=49)

Structured PICO

Does pulmonary vein isolation using the second-generation 28 mm cryoballoon prevent atrial tachyarrhythmia recurrence in patients with persistent atrial fibrillation?

P
Population
49 patients with persistent atrial fibrillation (mean age 63 years, 41% female) who underwent pulmonary vein isolation using the second-generation 28 mm cryoballoon, followed for a mean of 416 days.
E
Exposure
Pulmonary vein isolation (PVI) using the second-generation 28 mm cryoballoon (freeze cycle duration 240 s, with or without a bonus freeze cycle).
O
Outcome
Recurrence of symptomatic and/or documented atrial tachyarrhythmia >30 s beyond the 3-month blanking period at 1 year.

Pulmonary vein isolation using the second-generation 28 mm cryoballoon in patients with persistent atrial fibrillation is associated with a 69% 1-year clinical success rate.

Abstract

AIMS: The purpose of this study was to determine efficacy of pulmonary vein isolation (PVI) using the 28 mm cryoballoon (CB) in patients with persistent atrial fibrillation (AF). Superior acute and 1-year outcome has been demonstrated following PVI, using the second-generation CB in patients with paroxysmal AF. Data on the outcome in patients with persistent AF are sparse. METHODS AND RESULTS: Forty-nine patients (20 female, mean age 63 ± 10 years, mean left atrial diameter 46 ± 5 mm) with persistent AF median AF duration since first diagnosis: 48 (20:192) months underwent second-generation 28 mm CB-based PVI. The freeze cycle duration was set at 240 s. After successful PVI, a bonus freeze cycle of 240 s was applied in the first 11/49 (22%) patients, and no bonus freeze cycle was used in the remaining 38/49 (78%) patients. Follow-up (FU) was based on outpatient clinic visits at 3, 6, and 12 months, which included Holter electrocardiograms and telephone interviews. Recurrence was defined as an episode of symptomatic and/or documented atrial tachyarrhythmia >30 s beyond the 3-month blanking period. A total of 193 pulmonary veins (PVs) were identified and 193/193 (100%) PVs were successfully isolated. No phrenic nerve paralysis occurred. Follow-up was obtained in 49/49 (100%) patients with a mean FU duration of 416 ± 178 days. After the 3-month blanking period, antiarrhythmic medication was discontinued in 33/49 (67%) patients. Thirty-four of 49 (69%) patients remained in stable sinus rhythm. CONCLUSIONS: In patients with persistent AF, use of the second-generation 28 mm CB was associated with a 69% 1-year clinical success rate.

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Cite This Study

Lemeš et al. (2015) conducted an observational in Persistent atrial fibrillation (n=49). Second-generation 28 mm cryoballoon-based pulmonary vein isolation was evaluated on 1-year clinical success rate (stable sinus rhythm without recurrence of atrial tachyarrhythmia >30 s beyond the 3-month blanking period). Pulmonary vein isolation using the second-generation 28 mm cryoballoon in patients with persistent atrial fibrillation was associated with a 69% 1-year clinical success rate.

synapsesocial.com/papers/6a21120838e3bbbbff02ae61https://doi.org/10.1093/europace/euv092
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