Pulmonary vein isolation as index procedure for persistent atrial fibrillation: One-year clinical outcome after ablation using the second-generation cryoballoon

Giuseppe Ciconte, Luca Ottaviano, Carlo De Asmundis, Giannis Baltogiannis, Giulio Conte, Juan Sieira, Giacomo Di Giovanni, Yukio Saitoh, Ghazala Irfan, Giacomo Mugnai, Cesare Storti, Annibale Sandro Montenero, Gian Battista Chierchia, Pedro Brugada

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: No data are available about the clinical outcome of pulmonary vein isolation (PVI) as an index procedure for persistent atrial fibrillation (PersAF) ablation using the second-generation cryoballoon (CB-Adv). OBJECTIVE: The purpose of this study was to assess the 1-year efficacy of PVI as an index procedure for PersAF ablation using the novel CB-Adv. METHODS: Sixty-three consecutive patients (45 male [71.4%], mean age 62.7 ± 9.7 years) with drug-refractory PersAF undergoing PVI using the novel CB-Adv were enrolled. Follow-up was based on outpatient clinic visits including Holter ECGs. Recurrence of atrial tachyarrhythmias (ATas) was defined as a symptomatic or documented episode >30 seconds. RESULTS: A total of 247 PVs were identified and successfully isolated with a mean of 1.7 ± 0.4 freezes. Mean procedural and fluoroscopy times were 87.1 ± 38.2 minutes and 14.9 ± 6.1 minutes, respectively. Among 26 of 63 patients (41.3%) presenting with AF at the beginning of the procedure, 7 of 26 (26.9%) converted to sinus rhythm during ablation. Phrenic nerve palsy occurred in 4 of 63 patients (6.3%). At 1-year follow-up, after a 3-month blanking period (BP), 38 of 63 patients (60.3%) were in sinus rhythm. Because of ATa recurrences, 9 patients underwent a second procedure with radiofrequency ablation showing a pulmonary vein reconnection in 4 right-sided PVs (44.4%) and 3 leftsided PVs (33.3%). Multivariate analysis demonstrated that PersAF duration (P = .01) and relapses during BP (P = .04) were independent predictors of AT recurrences. CONCLUSION At 1-year follow-up, freedom from ATas following PersAF ablation with the novel CB-Adv is 60%. Phrenic nerve palsy is the most common complication. PersAF duration and relapses during the BP appear to be significant predictors of arrhythmic recurrences.

Original languageEnglish
Pages (from-to)60-66
Number of pages7
JournalHeart Rhythm
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Keywords

  • Cryoballoon ablation
  • One-year follow-up
  • Persistent atrial fibrillation
  • Pulmonary vein isolation
  • Second-generation cryoballoon

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Fingerprint Dive into the research topics of 'Pulmonary vein isolation as index procedure for persistent atrial fibrillation: One-year clinical outcome after ablation using the second-generation cryoballoon'. Together they form a unique fingerprint.

Cite this