Electrophysiological findings following pulmonary vein isolation using radiofrequency catheter guided by contact-force and second-generation cryoballoon: Lessons from repeat ablation procedures

Giuseppe Ciconte, Vedran Velagić, Giacomo Mugnai, Yukio Saitoh, Ghazala Irfan, Burak Hunuk, Erwin Ströker, Giulio Conte, Juan Sieira, Giacomo Di Giovanni, Giannis Baltogiannis, Pedro Brugada, Carlo De Asmundis, Gian Battista Chierchia

Research output: Contribution to journalArticle

Abstract

Aims To assess the incidence of late pulmonary vein (PV) reconnection following index PV isolation (PVI) procedure initially achieved with radiofrequency contact-force catheter ablation (CFCA) and second-generation cryoballoon ablation (CB-AdvA). Methods and results A total of 56 consecutive patients (41 male, 73.2%; mean age 60.8 ± 11.8 years) underwent a repeat ablation because of recurrent atrial tachyarrhythmias (ATas) after index PVI achieved with CFCA (30 patients) or CB-AdvA (26 patients). All repeat procedures were performed by the means of CFCA. In the CFCA group, among 119 PVs, 43 (36.1%) showed conduction gaps in 24 patients (1.8 per patient), whereas in the CB-AdvA group among 103 veins, 21 (20.4%) showed a PV reconnection in 18 patients (1.2 per patient) (P = 0.01). The left superior pulmonary vein was less frequently reconnected following CB-AdvA when compared with CFCA (2/25, 8% vs. 11/29, 37.9%; P = 0.01). In the CFCA group, the mean CF per-vein was lower in reconnecting veins when compared with those persistently isolated (10.9 ± 2.7 vs. 18.6 ± 3.1 g; P <0.001). In the CB-AdvA group, late PV reconnection was associated with warmer nadir temperature (-48.9 ± 5.1 vs. -51.2 ± 4.7°C; P = 0.05) and longer time-to-isolation (71.1 ± 20.2 vs. 50.2 ± 32.9 s; P = 0.03). Conclusion The rate of late PV reconnection is significantly lower following CB-AdvA when compared with CFCA as index procedure. Lower CF values and warmer nadir temperature with longer time to effect were more frequently associated with PV reconnections in the setting of CFCA and CB-AdvA.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalEuropace
Volume18
Issue number1
DOIs
Publication statusPublished - Dec 28 2015

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Keywords

  • Atrial fibrillation
  • Contact-force radiofrequency catheter ablation
  • Cryoballoon ablation
  • Pulmonary vein isolation
  • Pulmonary vein reconnection
  • Second-generation cryoballoon

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Ciconte, G., Velagić, V., Mugnai, G., Saitoh, Y., Irfan, G., Hunuk, B., Ströker, E., Conte, G., Sieira, J., Di Giovanni, G., Baltogiannis, G., Brugada, P., De Asmundis, C., & Chierchia, G. B. (2015). Electrophysiological findings following pulmonary vein isolation using radiofrequency catheter guided by contact-force and second-generation cryoballoon: Lessons from repeat ablation procedures. Europace, 18(1), 71-77. https://doi.org/10.1093/europace/euv224