Single freeze per vein strategy with the second-generation cryoballoon for atrial fibrillation: a propensity score-matched study between 180- and 240-s application time in a large cohort of patients

Valentina De Regibus, Juan Pablo Abugattas, Saverio Iacopino, Giacomo Mugnai, Cesare Storti, Giulio Conte, Angelo Auricchio, Erwin Ströker, Hugo Enrique Coutiño, Ken Takarada, Francesca Salghetti, Ian Lusoc, Lucio Capulzini, Pedro Brugada, Carlo de Asmundis, Gian Battista Chierchia

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Aims: The single-freeze strategy using the second-generation cryoballoon (CB-A, Arctic Front Advance, Medtronic, Minneapolis, MN, USA) has been reported to be as effective as the recommended double-freeze approach in several single-centre studies. In this retrospective, international, multicentre study, we compare the 3-min single-freeze strategy with the 4-min single-freeze strategy. Methods and results: Four hundred and thirty-two patients having undergone pulmonary vein isolation (PVI) by means of CB-A using a single-freeze strategy were considered for this analysis. A cohort of patients who were treated with a 3-min strategy (Group 1) was compared with a propensity score-matched cohort of patients who underwent a 4-min strategy (Group 2). Pulmonary vein isolation was successfully achieved in all the veins using the 28-mm CB-A. The procedural and fluoroscopy times were lower in Group 1 (67.8 ± 17 vs. 73.8 ± 26.3, P < 0.05; 14.9 ± 7.8 vs. 24.2 ± 10.6 min, P < 0.05). The most frequent complication was PNP, with no difference between the two groups (P = 0.67). After a mean follow-up of 13 ± 8 months, taking into consideration a blanking period of 3 months, 85.6% of patients in Group 1 and 87% of patients in Group 2 were free from arrhythmia recurrence at final follow-up (P = 0.67). Conclusion: There is no difference in acute success, rate of complications, and freedom from atrial fibrillation recurrences during the follow-up between 3-min and 4-min per vein freeze strategies. The procedural and fluoroscopy times were significantly shorter in 3-min per vein strategy.

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Propensity Score
Atrial Fibrillation
Veins
Pulmonary Veins
Fluoroscopy
Recurrence
Multicenter Studies
Cardiac Arrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Single freeze per vein strategy with the second-generation cryoballoon for atrial fibrillation : a propensity score-matched study between 180- and 240-s application time in a large cohort of patients. / De Regibus, Valentina; Abugattas, Juan Pablo; Iacopino, Saverio; Mugnai, Giacomo; Storti, Cesare; Conte, Giulio; Auricchio, Angelo; Ströker, Erwin; Coutiño, Hugo Enrique; Takarada, Ken; Salghetti, Francesca; Lusoc, Ian; Capulzini, Lucio; Brugada, Pedro; de Asmundis, Carlo; Chierchia, Gian Battista.

In: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, Vol. 20, No. FI3, 01.11.2018, p. f377-f383.

Research output: Contribution to journalArticle

De Regibus, Valentina ; Abugattas, Juan Pablo ; Iacopino, Saverio ; Mugnai, Giacomo ; Storti, Cesare ; Conte, Giulio ; Auricchio, Angelo ; Ströker, Erwin ; Coutiño, Hugo Enrique ; Takarada, Ken ; Salghetti, Francesca ; Lusoc, Ian ; Capulzini, Lucio ; Brugada, Pedro ; de Asmundis, Carlo ; Chierchia, Gian Battista. / Single freeze per vein strategy with the second-generation cryoballoon for atrial fibrillation : a propensity score-matched study between 180- and 240-s application time in a large cohort of patients. In: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2018 ; Vol. 20, No. FI3. pp. f377-f383.
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abstract = "Aims: The single-freeze strategy using the second-generation cryoballoon (CB-A, Arctic Front Advance, Medtronic, Minneapolis, MN, USA) has been reported to be as effective as the recommended double-freeze approach in several single-centre studies. In this retrospective, international, multicentre study, we compare the 3-min single-freeze strategy with the 4-min single-freeze strategy. Methods and results: Four hundred and thirty-two patients having undergone pulmonary vein isolation (PVI) by means of CB-A using a single-freeze strategy were considered for this analysis. A cohort of patients who were treated with a 3-min strategy (Group 1) was compared with a propensity score-matched cohort of patients who underwent a 4-min strategy (Group 2). Pulmonary vein isolation was successfully achieved in all the veins using the 28-mm CB-A. The procedural and fluoroscopy times were lower in Group 1 (67.8 ± 17 vs. 73.8 ± 26.3, P < 0.05; 14.9 ± 7.8 vs. 24.2 ± 10.6 min, P < 0.05). The most frequent complication was PNP, with no difference between the two groups (P = 0.67). After a mean follow-up of 13 ± 8 months, taking into consideration a blanking period of 3 months, 85.6{\%} of patients in Group 1 and 87{\%} of patients in Group 2 were free from arrhythmia recurrence at final follow-up (P = 0.67). Conclusion: There is no difference in acute success, rate of complications, and freedom from atrial fibrillation recurrences during the follow-up between 3-min and 4-min per vein freeze strategies. The procedural and fluoroscopy times were significantly shorter in 3-min per vein strategy.",
author = "{De Regibus}, Valentina and Abugattas, {Juan Pablo} and Saverio Iacopino and Giacomo Mugnai and Cesare Storti and Giulio Conte and Angelo Auricchio and Erwin Str{\"o}ker and Couti{\~n}o, {Hugo Enrique} and Ken Takarada and Francesca Salghetti and Ian Lusoc and Lucio Capulzini and Pedro Brugada and {de Asmundis}, Carlo and Chierchia, {Gian Battista}",
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T1 - Single freeze per vein strategy with the second-generation cryoballoon for atrial fibrillation

T2 - a propensity score-matched study between 180- and 240-s application time in a large cohort of patients

AU - De Regibus, Valentina

AU - Abugattas, Juan Pablo

AU - Iacopino, Saverio

AU - Mugnai, Giacomo

AU - Storti, Cesare

AU - Conte, Giulio

AU - Auricchio, Angelo

AU - Ströker, Erwin

AU - Coutiño, Hugo Enrique

AU - Takarada, Ken

AU - Salghetti, Francesca

AU - Lusoc, Ian

AU - Capulzini, Lucio

AU - Brugada, Pedro

AU - de Asmundis, Carlo

AU - Chierchia, Gian Battista

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Aims: The single-freeze strategy using the second-generation cryoballoon (CB-A, Arctic Front Advance, Medtronic, Minneapolis, MN, USA) has been reported to be as effective as the recommended double-freeze approach in several single-centre studies. In this retrospective, international, multicentre study, we compare the 3-min single-freeze strategy with the 4-min single-freeze strategy. Methods and results: Four hundred and thirty-two patients having undergone pulmonary vein isolation (PVI) by means of CB-A using a single-freeze strategy were considered for this analysis. A cohort of patients who were treated with a 3-min strategy (Group 1) was compared with a propensity score-matched cohort of patients who underwent a 4-min strategy (Group 2). Pulmonary vein isolation was successfully achieved in all the veins using the 28-mm CB-A. The procedural and fluoroscopy times were lower in Group 1 (67.8 ± 17 vs. 73.8 ± 26.3, P < 0.05; 14.9 ± 7.8 vs. 24.2 ± 10.6 min, P < 0.05). The most frequent complication was PNP, with no difference between the two groups (P = 0.67). After a mean follow-up of 13 ± 8 months, taking into consideration a blanking period of 3 months, 85.6% of patients in Group 1 and 87% of patients in Group 2 were free from arrhythmia recurrence at final follow-up (P = 0.67). Conclusion: There is no difference in acute success, rate of complications, and freedom from atrial fibrillation recurrences during the follow-up between 3-min and 4-min per vein freeze strategies. The procedural and fluoroscopy times were significantly shorter in 3-min per vein strategy.

AB - Aims: The single-freeze strategy using the second-generation cryoballoon (CB-A, Arctic Front Advance, Medtronic, Minneapolis, MN, USA) has been reported to be as effective as the recommended double-freeze approach in several single-centre studies. In this retrospective, international, multicentre study, we compare the 3-min single-freeze strategy with the 4-min single-freeze strategy. Methods and results: Four hundred and thirty-two patients having undergone pulmonary vein isolation (PVI) by means of CB-A using a single-freeze strategy were considered for this analysis. A cohort of patients who were treated with a 3-min strategy (Group 1) was compared with a propensity score-matched cohort of patients who underwent a 4-min strategy (Group 2). Pulmonary vein isolation was successfully achieved in all the veins using the 28-mm CB-A. The procedural and fluoroscopy times were lower in Group 1 (67.8 ± 17 vs. 73.8 ± 26.3, P < 0.05; 14.9 ± 7.8 vs. 24.2 ± 10.6 min, P < 0.05). The most frequent complication was PNP, with no difference between the two groups (P = 0.67). After a mean follow-up of 13 ± 8 months, taking into consideration a blanking period of 3 months, 85.6% of patients in Group 1 and 87% of patients in Group 2 were free from arrhythmia recurrence at final follow-up (P = 0.67). Conclusion: There is no difference in acute success, rate of complications, and freedom from atrial fibrillation recurrences during the follow-up between 3-min and 4-min per vein freeze strategies. The procedural and fluoroscopy times were significantly shorter in 3-min per vein strategy.

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