Cryoballoon Ablation for Pulmonary Vein Isolation in Patients with Persistent Atrial Fibrillation

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Cryoballoon Ablation for Pulmonary Vein Isolation in Patients with Persistent Atrial Fibrillation: One-Year Outcome Using Second Generation Cryoballoon

  1. Marc Horlitz1

-Author Affiliations

  1. 1Department of Cardiology/Electrophysiology, Witten/Herdecke University, Krankenhaus Porz am Rhein, Cologne, Germany
  2. 2Klinikum Lüdenscheid Klinik für Innere Medizin V, Lüdenscheid, Germany
  3. 3Department of Radiology, Witten/Herdecke University, Krankenhaus Porz am Rhein, Cologne, Germany
  1. ↵* Witten/Herdecke University, Krankenhaus Porz am Rhein, Department of Cardiology/Electrophysiology, Urbacher Weg 19, 51149 Köln-Porz, Germanyb.koektuerk@web.de

  2. Abstract

    Background—Data regarding the freedom from atrial fibrillation (AF) in the follow-up of persistent AF patients is limited. The second-generation cryoballoon has better cooling properties compared to first generation. In this study we aimed to assess the medium term efficacy of second generation cryoballoon in patients with persistent AF.

    Methods and Results—A total of 100 patients (63±10 years, 80% male) patients with symptomatic persistent AF despite ≥1 antiarrhythmic drug(s) who were scheduled for pulmonary vein isolation using second generation cryoballoon were enrolled in this study. Follow-up was based on outpatient clinic visits including Holter ECGs. Recurrence was defined as a symptomatic or documented arrhythmia episode of >30 seconds excluding a 3-month blanking period. As a result 393 PVs (7 patients with common ostium) were successfully isolated. Mean procedural and fluoroscopy times were 96.2±21.3 minutes and 19.7±6.7 minutes, respectively. Phrenic nerve palsy occurred in 3% (3/100) of the patients. At a mean follow-up duration of 10.6±6.3 months, 67% of the patients were in sinus rhythm. Stepwise multivariable Cox proportional hazard regression analysis showed that early AF recurrence (HR: 3.83, 95% CI: 1.91 - 7.68, p <0.001) was the only independent predictor for late AF recurrence apart from other clinical and echocardiographic variables.

    Conclusions—Our findings indicated that second generation cryoballoon use is associated with favorable outcomes in patients with persistent AF. Recurrence at blanking period was only predictor of long term AF recurrence.