Center experience does not influence long-term outcome and peri-procedural complications after cryoballoon ablation of paroxysmal atrial fibrillation: Data on 860 patients from the real-world multicenter observational project

Maurizio Landolina, Giuseppe Arena, Saverio Iacopino, Roberto Verlato, Paolo Pieragnoli, Antonio Curnis, Maurizio Lunati, Werner Rauhe, Gaetano Senatore, Luigi Sciarra, Giulio Molon, Pietro Maria G. Agricola, Luigi Padeletti, Claudio Tondo

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this research was to evaluate whether the procedural data, the incidence of complications, and the long-term freedom from atrial fibrillation (AF) recurrences are influenced by center experience in a paroxysmal AF (PAF) population performing a first-time pulmonary vein isolation (PVI) by cryoballoon ablation (CBA). Methods: A total of 860 patients underwent PVI by CBA. Center experience groups were predefined according to the quartiles of the distribution regarding the amount of performed procedures: 3.1%, 10.6%, 22.7% and 63.6% of patients were respectively followed in each group from 1st (less experienced) to 4th (more experienced) quartile of experience. Results: In the entire population, median procedure and fluoroscopy time were 105 and 25 min, respectively. The median procedure time significantly decreased from 130 to 90 min (P < 0.001) as the center's experience increased. In 47 (5.5%) patients, a peri-procedural complication occurred. As the experience of centers increased, the acute intraprocedural PVI success rate increased (from 94.3% to 98.9%, P = 0.007), whereas there was a tendency towards a decreased incidence of peri-procedure complications (from 7.4% to 4.6%, P = 0.998). The mean 1-year freedom from AF recurrence probability was 78.3%, and the 18-month mean was 68.9% with no difference among the groups with different levels of experience. Conclusion: CBA is a safe and effective treatment for patients with PAF. Peri-procedural complications and procedural times were low in all the analyzed sub-groups, showing a decreasing trend in function of center expertise. The long-term freedom from AF recurrence was not influenced by the level of experience. (clinicaltrials.gov: NCT01007474)

Original languageEnglish
Pages (from-to)130-136
Number of pages7
JournalInternational Journal of Cardiology
Volume272
DOIs
Publication statusPublished - Dec 1 2018

Keywords

  • Ablation of atrial fibrillation
  • AF recurrence
  • Atrial fibrillation
  • Cryoablation
  • Outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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