TY - JOUR
T1 - Efficacy of cryoballoon ablation in patients with paroxysmal atrial fibrillation without time to pulmonary vein isolation assessment
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
Y1 - 2018/12/1
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
UR - http://www.scopus.com/inward/record.url?scp=85050148440&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050148440&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2018.07.070
DO - 10.1016/j.ijcard.2018.07.070
M3 - Article
C2 - 30037629
AN - SCOPUS:85050148440
VL - 272
SP - 118
EP - 122
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -