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Published online: 2020-10-30
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Clinical outcomes of cryoballoon ablation for pulmonary vein isolation: Impact of intraprocedural heart rhythm

Bruno Reissmann, Christian-H. Heeger, Karena Opitz, Michael Schlüter, Peter Wohlmuth, Laura Rottner, Thomas Fink, Jin-Hong Gerds-Li, Shibu Mathew, Christine Lemes, Tilman Maurer, Feifan Ouyang, Karl-Heinz Kuck, Andreas Rillig, Doreen Schöppenthau, Andreas Metzner
DOI: 10.5603/CJ.a2020.0147
·
Pubmed: 33140384

open access

Ahead of print
Original articles
Published online: 2020-10-30

Abstract

Background: The current study sought to assess the impact of the intraprocedural heart rhythm (sinus rhythm [SR] vs. atrial fibrillation [AF]) on acute procedural characteristics, durability of pulmonary vein isolation (PVI) and long-term clinical outcomes of cryoballoon (CB) ablation.

Methods: A total of 195 patients with symptomatic paroxysmal (n = 136) or persistent AF (n = 59) underwent CB-based PVI. Ablation procedures were either performed in SR (SR group; n = 147) or during AF (AF group; n = 48). Persistent AF was more frequent in the AF group than in the SR group (62% vs. 20%). All other patient baseline characteristics did not differ between the two groups.

Results: The nadir temperature during the CB applications was significantly lower in the AF group than in patients in the SR group (–49 [interquartile range, –44; –54]°C vs. –47 [-42; –52]°C, p = 0.002). Median procedure and fluoroscopy times as well as the rate of real-time recordings were not different between the two groups. Repeat ablation for the treatment of atrial arrhythmia recurrence was performed in 60 patients (SR: 44 [30%] patients; AF: 16 [33%] patients), with a trend towards a lower rate of PV reconnections in the AF group (p = 0.07). There was no difference in 3-year arrhythmia-free survival (p = 0.8).

Conclusions: Cryoballoon-based PVI during AF results in lower nadir balloon temperatures and a trend towards a higher durability of PVI as compared to procedures performed in SR. The rate of real-time PVI recordings was not affected by the intraprocedural heart rhythm.

Abstract

Background: The current study sought to assess the impact of the intraprocedural heart rhythm (sinus rhythm [SR] vs. atrial fibrillation [AF]) on acute procedural characteristics, durability of pulmonary vein isolation (PVI) and long-term clinical outcomes of cryoballoon (CB) ablation.

Methods: A total of 195 patients with symptomatic paroxysmal (n = 136) or persistent AF (n = 59) underwent CB-based PVI. Ablation procedures were either performed in SR (SR group; n = 147) or during AF (AF group; n = 48). Persistent AF was more frequent in the AF group than in the SR group (62% vs. 20%). All other patient baseline characteristics did not differ between the two groups.

Results: The nadir temperature during the CB applications was significantly lower in the AF group than in patients in the SR group (–49 [interquartile range, –44; –54]°C vs. –47 [-42; –52]°C, p = 0.002). Median procedure and fluoroscopy times as well as the rate of real-time recordings were not different between the two groups. Repeat ablation for the treatment of atrial arrhythmia recurrence was performed in 60 patients (SR: 44 [30%] patients; AF: 16 [33%] patients), with a trend towards a lower rate of PV reconnections in the AF group (p = 0.07). There was no difference in 3-year arrhythmia-free survival (p = 0.8).

Conclusions: Cryoballoon-based PVI during AF results in lower nadir balloon temperatures and a trend towards a higher durability of PVI as compared to procedures performed in SR. The rate of real-time PVI recordings was not affected by the intraprocedural heart rhythm.

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Keywords

clinical outcomes, cryoballoon ablation, pulmonary vein isolation, intraprocedural heart rhythm

About this article
Title

Clinical outcomes of cryoballoon ablation for pulmonary vein isolation: Impact of intraprocedural heart rhythm

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Research paper

Published online

2020-10-30

DOI

10.5603/CJ.a2020.0147

Pubmed

33140384

Keywords

clinical outcomes
cryoballoon ablation
pulmonary vein isolation
intraprocedural heart rhythm

Authors

Bruno Reissmann
Christian-H. Heeger
Karena Opitz
Michael Schlüter
Peter Wohlmuth
Laura Rottner
Thomas Fink
Jin-Hong Gerds-Li
Shibu Mathew
Christine Lemes
Tilman Maurer
Feifan Ouyang
Karl-Heinz Kuck
Andreas Rillig
Doreen Schöppenthau
Andreas Metzner

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