Efficacy of cryoballoon ablation in patients with paroxysmal atrial fibrillation without time to pulmonary vein isolation assessment

Giuseppe Stabile, Claudio Tondo, Antonio Curnis, Maurizio Lunati, Massimiliano Manfrin, Giulio Molon, Luigi Sciarra, Massimo Mantica, Saverio Iacopino, Giuseppe Arena, Maurizio Landolina, Alberto Arestia, Roberto Verlato

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Real-time visualization of the electrical activity of the pulmonary veins (PV) is not always possible in the setting of atrial fibrillation (AF) cryoballoon ablation. We investigated the relation between the effective documentation of time to PV isolation and the clinical outcome in a cohort of patients with paroxysmal AF who underwent cryoballoon ablation. Methods: One thousand forty two consecutive patients were enrolled. An inner lumen mapping catheter was typically used to visualize real-time electrical activity inside the PVs. Results: Time to PV isolation was documented in all targeted PVs in 391 patients (Group 1), in 651 patients it was not possible to record PV potentials and assess time to PV isolation in at least one PV (Group 2). In Group 1 a longer procedure duration and ablation time were observed, while a longer fluoroscopy time was observed in Group 2. After a mean follow-up of 14 ± 11 months, 209/1042 (20%) patients had an atrial arrhythmia recurrence (20.2% in Group 1, 19.9% in Group 2, p = 0.25). Complications occurred in 54/1042 (5.2%) patients without any difference among the two study groups. Conclusion: In our retrospective analysis, in about two thirds of patients undergoing cryoballoon ablation it was not possible to acutely assess time to PV isolation in all PVs. However, one-year freedom from clinically symptomatic atrial tachyarrhythmia was similar to that of patients in which time to PV isolation was documented in all targeted veins. Clinical Trial Registration: clinicaltrials.gov (NCT01007474).

Original languageEnglish
Pages (from-to)118-122
Number of pages5
JournalInternational Journal of Cardiology
Volume272
DOIs
Publication statusPublished - Dec 1 2018

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Pulmonary Veins
Atrial Fibrillation
Fluoroscopy
Tachycardia
Documentation
Cardiac Arrhythmias
Veins
Catheters
Clinical Trials
Recurrence

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Cryoballoon
  • Mid-term outcome
  • Pulmonary vein isolation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Efficacy of cryoballoon ablation in patients with paroxysmal atrial fibrillation without time to pulmonary vein isolation assessment. / Stabile, Giuseppe; Tondo, Claudio; Curnis, Antonio; Lunati, Maurizio; Manfrin, Massimiliano; Molon, Giulio; Sciarra, Luigi; Mantica, Massimo; Iacopino, Saverio; Arena, Giuseppe; Landolina, Maurizio; Arestia, Alberto; Verlato, Roberto.

In: International Journal of Cardiology, Vol. 272, 01.12.2018, p. 118-122.

Research output: Contribution to journalArticle

Stabile, G, Tondo, C, Curnis, A, Lunati, M, Manfrin, M, Molon, G, Sciarra, L, Mantica, M, Iacopino, S, Arena, G, Landolina, M, Arestia, A & Verlato, R 2018, 'Efficacy of cryoballoon ablation in patients with paroxysmal atrial fibrillation without time to pulmonary vein isolation assessment', International Journal of Cardiology, vol. 272, pp. 118-122. https://doi.org/10.1016/j.ijcard.2018.07.070
Stabile, Giuseppe ; Tondo, Claudio ; Curnis, Antonio ; Lunati, Maurizio ; Manfrin, Massimiliano ; Molon, Giulio ; Sciarra, Luigi ; Mantica, Massimo ; Iacopino, Saverio ; Arena, Giuseppe ; Landolina, Maurizio ; Arestia, Alberto ; Verlato, Roberto. / Efficacy of cryoballoon ablation in patients with paroxysmal atrial fibrillation without time to pulmonary vein isolation assessment. In: International Journal of Cardiology. 2018 ; Vol. 272. pp. 118-122.
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abstract = "Background: Real-time visualization of the electrical activity of the pulmonary veins (PV) is not always possible in the setting of atrial fibrillation (AF) cryoballoon ablation. We investigated the relation between the effective documentation of time to PV isolation and the clinical outcome in a cohort of patients with paroxysmal AF who underwent cryoballoon ablation. Methods: One thousand forty two consecutive patients were enrolled. An inner lumen mapping catheter was typically used to visualize real-time electrical activity inside the PVs. Results: Time to PV isolation was documented in all targeted PVs in 391 patients (Group 1), in 651 patients it was not possible to record PV potentials and assess time to PV isolation in at least one PV (Group 2). In Group 1 a longer procedure duration and ablation time were observed, while a longer fluoroscopy time was observed in Group 2. After a mean follow-up of 14 ± 11 months, 209/1042 (20{\%}) patients had an atrial arrhythmia recurrence (20.2{\%} in Group 1, 19.9{\%} in Group 2, p = 0.25). Complications occurred in 54/1042 (5.2{\%}) patients without any difference among the two study groups. Conclusion: In our retrospective analysis, in about two thirds of patients undergoing cryoballoon ablation it was not possible to acutely assess time to PV isolation in all PVs. However, one-year freedom from clinically symptomatic atrial tachyarrhythmia was similar to that of patients in which time to PV isolation was documented in all targeted veins. Clinical Trial Registration: clinicaltrials.gov (NCT01007474).",
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AU - Stabile, Giuseppe

AU - Tondo, Claudio

AU - Curnis, Antonio

AU - Lunati, Maurizio

AU - Manfrin, Massimiliano

AU - Molon, Giulio

AU - Sciarra, Luigi

AU - Mantica, Massimo

AU - Iacopino, Saverio

AU - Arena, Giuseppe

AU - Landolina, Maurizio

AU - Arestia, Alberto

AU - Verlato, Roberto

PY - 2018/12/1

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N2 - Background: Real-time visualization of the electrical activity of the pulmonary veins (PV) is not always possible in the setting of atrial fibrillation (AF) cryoballoon ablation. We investigated the relation between the effective documentation of time to PV isolation and the clinical outcome in a cohort of patients with paroxysmal AF who underwent cryoballoon ablation. Methods: One thousand forty two consecutive patients were enrolled. An inner lumen mapping catheter was typically used to visualize real-time electrical activity inside the PVs. Results: Time to PV isolation was documented in all targeted PVs in 391 patients (Group 1), in 651 patients it was not possible to record PV potentials and assess time to PV isolation in at least one PV (Group 2). In Group 1 a longer procedure duration and ablation time were observed, while a longer fluoroscopy time was observed in Group 2. After a mean follow-up of 14 ± 11 months, 209/1042 (20%) patients had an atrial arrhythmia recurrence (20.2% in Group 1, 19.9% in Group 2, p = 0.25). Complications occurred in 54/1042 (5.2%) patients without any difference among the two study groups. Conclusion: In our retrospective analysis, in about two thirds of patients undergoing cryoballoon ablation it was not possible to acutely assess time to PV isolation in all PVs. However, one-year freedom from clinically symptomatic atrial tachyarrhythmia was similar to that of patients in which time to PV isolation was documented in all targeted veins. Clinical Trial Registration: clinicaltrials.gov (NCT01007474).

AB - Background: Real-time visualization of the electrical activity of the pulmonary veins (PV) is not always possible in the setting of atrial fibrillation (AF) cryoballoon ablation. We investigated the relation between the effective documentation of time to PV isolation and the clinical outcome in a cohort of patients with paroxysmal AF who underwent cryoballoon ablation. Methods: One thousand forty two consecutive patients were enrolled. An inner lumen mapping catheter was typically used to visualize real-time electrical activity inside the PVs. Results: Time to PV isolation was documented in all targeted PVs in 391 patients (Group 1), in 651 patients it was not possible to record PV potentials and assess time to PV isolation in at least one PV (Group 2). In Group 1 a longer procedure duration and ablation time were observed, while a longer fluoroscopy time was observed in Group 2. After a mean follow-up of 14 ± 11 months, 209/1042 (20%) patients had an atrial arrhythmia recurrence (20.2% in Group 1, 19.9% in Group 2, p = 0.25). Complications occurred in 54/1042 (5.2%) patients without any difference among the two study groups. Conclusion: In our retrospective analysis, in about two thirds of patients undergoing cryoballoon ablation it was not possible to acutely assess time to PV isolation in all PVs. However, one-year freedom from clinically symptomatic atrial tachyarrhythmia was similar to that of patients in which time to PV isolation was documented in all targeted veins. Clinical Trial Registration: clinicaltrials.gov (NCT01007474).

KW - Atrial fibrillation

KW - Catheter ablation

KW - Cryoballoon

KW - Mid-term outcome

KW - Pulmonary vein isolation

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