A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real-world multicenter experience of 1STOP

Saverio Iacopino, Paolo Pieragnoli, Giuseppe Arena, Luigi Sciarra, Maurizio Landolina, Massimiliano Manfrin, Roberto Verlato, Francesco Solimene, Riccardo Sacchi, Luca Rebellato, Giovanni Rovaris, Giulio Molon, Tommaso Infusino, Claudio Tondo

Research output: Contribution to journalArticle

Abstract

Introduction: Four generations of the cryoballoon (CB) catheter were retrospectively evaluated in a real-world examination of patients with atrial fibrillation (AF). Methods and Results: Four hundred eighty patients (27% female and 60 ± 10 years) suffering from AF, underwent pulmonary vein (PV) ablation with one-of-four generations of the CB catheter. The total cohort was divided into four groups of patients: 120 with first-generation (CB-1); 120 with second-generation (CB-2); 120 with third-generation (CB-3); and 120 with fourth-generation (CB-4). Equal group sizes were achieved by examining the last 120 patients treated in each cohort, attempting to minimize the effect of a learning curve between the generations of CB catheter. Baseline clinical and patient characteristics were similar between the four cohorts, excepting age and the number of tested antiarrhythmic drugs. Procedure, fluoroscopy, and left atrial dwell times were significantly lower in the CB-4 cohort compared to previous generations of the CB catheters, while the acute procedural success rate was comparable across all catheter groups (>99%). Total acute procedural complications were low (2.5%), and acute complications were comparable within the CB-2, CB-3, and CB-4 groups (0.8% reported in each cohort). The rate of time-to-isolation (TTI) visualization increased with later generations of the CB catheters. Conclusions: The novel CB-4 achieved significantly faster procedural ablation times in comparison to the previous generations, while still maintaining a low rate of acute complications. Also, the rate of TTI visualization was observed to be higher with the CB-4 catheter. Further long-term evaluation is necessary, including an assessment of AF recurrence and PV reconnection(s).

Original languageEnglish
Pages (from-to)80-88
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 1 2020

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Catheters
Atrial Fibrillation
Pulmonary Veins
Learning Curve
Anti-Arrhythmia Agents
Fluoroscopy
Recurrence

Keywords

  • atrial fibrillation
  • catheter ablation
  • cryoablation
  • cryoballoon catheter generation
  • pulmonary vein isolations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real-world multicenter experience of 1STOP. / Iacopino, Saverio; Pieragnoli, Paolo; Arena, Giuseppe; Sciarra, Luigi; Landolina, Maurizio; Manfrin, Massimiliano; Verlato, Roberto; Solimene, Francesco; Sacchi, Riccardo; Rebellato, Luca; Rovaris, Giovanni; Molon, Giulio; Infusino, Tommaso; Tondo, Claudio.

In: Journal of Cardiovascular Electrophysiology, Vol. 31, No. 1, 01.01.2020, p. 80-88.

Research output: Contribution to journalArticle

Iacopino, S, Pieragnoli, P, Arena, G, Sciarra, L, Landolina, M, Manfrin, M, Verlato, R, Solimene, F, Sacchi, R, Rebellato, L, Rovaris, G, Molon, G, Infusino, T & Tondo, C 2020, 'A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real-world multicenter experience of 1STOP', Journal of Cardiovascular Electrophysiology, vol. 31, no. 1, pp. 80-88. https://doi.org/10.1111/jce.14271
Iacopino, Saverio ; Pieragnoli, Paolo ; Arena, Giuseppe ; Sciarra, Luigi ; Landolina, Maurizio ; Manfrin, Massimiliano ; Verlato, Roberto ; Solimene, Francesco ; Sacchi, Riccardo ; Rebellato, Luca ; Rovaris, Giovanni ; Molon, Giulio ; Infusino, Tommaso ; Tondo, Claudio. / A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real-world multicenter experience of 1STOP. In: Journal of Cardiovascular Electrophysiology. 2020 ; Vol. 31, No. 1. pp. 80-88.
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abstract = "Introduction: Four generations of the cryoballoon (CB) catheter were retrospectively evaluated in a real-world examination of patients with atrial fibrillation (AF). Methods and Results: Four hundred eighty patients (27{\%} female and 60 ± 10 years) suffering from AF, underwent pulmonary vein (PV) ablation with one-of-four generations of the CB catheter. The total cohort was divided into four groups of patients: 120 with first-generation (CB-1); 120 with second-generation (CB-2); 120 with third-generation (CB-3); and 120 with fourth-generation (CB-4). Equal group sizes were achieved by examining the last 120 patients treated in each cohort, attempting to minimize the effect of a learning curve between the generations of CB catheter. Baseline clinical and patient characteristics were similar between the four cohorts, excepting age and the number of tested antiarrhythmic drugs. Procedure, fluoroscopy, and left atrial dwell times were significantly lower in the CB-4 cohort compared to previous generations of the CB catheters, while the acute procedural success rate was comparable across all catheter groups (>99{\%}). Total acute procedural complications were low (2.5{\%}), and acute complications were comparable within the CB-2, CB-3, and CB-4 groups (0.8{\%} reported in each cohort). The rate of time-to-isolation (TTI) visualization increased with later generations of the CB catheters. Conclusions: The novel CB-4 achieved significantly faster procedural ablation times in comparison to the previous generations, while still maintaining a low rate of acute complications. Also, the rate of TTI visualization was observed to be higher with the CB-4 catheter. Further long-term evaluation is necessary, including an assessment of AF recurrence and PV reconnection(s).",
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T1 - A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real-world multicenter experience of 1STOP

AU - Iacopino, Saverio

AU - Pieragnoli, Paolo

AU - Arena, Giuseppe

AU - Sciarra, Luigi

AU - Landolina, Maurizio

AU - Manfrin, Massimiliano

AU - Verlato, Roberto

AU - Solimene, Francesco

AU - Sacchi, Riccardo

AU - Rebellato, Luca

AU - Rovaris, Giovanni

AU - Molon, Giulio

AU - Infusino, Tommaso

AU - Tondo, Claudio

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Introduction: Four generations of the cryoballoon (CB) catheter were retrospectively evaluated in a real-world examination of patients with atrial fibrillation (AF). Methods and Results: Four hundred eighty patients (27% female and 60 ± 10 years) suffering from AF, underwent pulmonary vein (PV) ablation with one-of-four generations of the CB catheter. The total cohort was divided into four groups of patients: 120 with first-generation (CB-1); 120 with second-generation (CB-2); 120 with third-generation (CB-3); and 120 with fourth-generation (CB-4). Equal group sizes were achieved by examining the last 120 patients treated in each cohort, attempting to minimize the effect of a learning curve between the generations of CB catheter. Baseline clinical and patient characteristics were similar between the four cohorts, excepting age and the number of tested antiarrhythmic drugs. Procedure, fluoroscopy, and left atrial dwell times were significantly lower in the CB-4 cohort compared to previous generations of the CB catheters, while the acute procedural success rate was comparable across all catheter groups (>99%). Total acute procedural complications were low (2.5%), and acute complications were comparable within the CB-2, CB-3, and CB-4 groups (0.8% reported in each cohort). The rate of time-to-isolation (TTI) visualization increased with later generations of the CB catheters. Conclusions: The novel CB-4 achieved significantly faster procedural ablation times in comparison to the previous generations, while still maintaining a low rate of acute complications. Also, the rate of TTI visualization was observed to be higher with the CB-4 catheter. Further long-term evaluation is necessary, including an assessment of AF recurrence and PV reconnection(s).

AB - Introduction: Four generations of the cryoballoon (CB) catheter were retrospectively evaluated in a real-world examination of patients with atrial fibrillation (AF). Methods and Results: Four hundred eighty patients (27% female and 60 ± 10 years) suffering from AF, underwent pulmonary vein (PV) ablation with one-of-four generations of the CB catheter. The total cohort was divided into four groups of patients: 120 with first-generation (CB-1); 120 with second-generation (CB-2); 120 with third-generation (CB-3); and 120 with fourth-generation (CB-4). Equal group sizes were achieved by examining the last 120 patients treated in each cohort, attempting to minimize the effect of a learning curve between the generations of CB catheter. Baseline clinical and patient characteristics were similar between the four cohorts, excepting age and the number of tested antiarrhythmic drugs. Procedure, fluoroscopy, and left atrial dwell times were significantly lower in the CB-4 cohort compared to previous generations of the CB catheters, while the acute procedural success rate was comparable across all catheter groups (>99%). Total acute procedural complications were low (2.5%), and acute complications were comparable within the CB-2, CB-3, and CB-4 groups (0.8% reported in each cohort). The rate of time-to-isolation (TTI) visualization increased with later generations of the CB catheters. Conclusions: The novel CB-4 achieved significantly faster procedural ablation times in comparison to the previous generations, while still maintaining a low rate of acute complications. Also, the rate of TTI visualization was observed to be higher with the CB-4 catheter. Further long-term evaluation is necessary, including an assessment of AF recurrence and PV reconnection(s).

KW - atrial fibrillation

KW - catheter ablation

KW - cryoablation

KW - cryoballoon catheter generation

KW - pulmonary vein isolations

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