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28.02.2018 | Original Paper

Safety and efficacy of persistent atrial fibrillation ablation using the second-generation cryoballoon

verfasst von: Kivanc Yalin, Amr Abdin, Evgeny Lyan, Noureddin Sawan, Spyridon Liosis, Christian Elsner, Alexander Jobs, Ben Brüggemann, Jelena Koester, Ingo Eitel, Charlotte Eitel, Roland Richard Tilz

Erschienen in: Clinical Research in Cardiology | Ausgabe 7/2018

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Abstract

Background

The second-generation cryoballoon (CB) is increasingly used for treatment of persistent atrial fibrillation (AF). Data regarding the clinical outcome and mechanism of arrhythmia recurrence following persistent AF ablation using CB is sparse. In this study, we aimed to assess the efficacy of CB and mechanisms of atrial tachyarrhythmia (ATA) recurrence in patients with persistent AF.

Methods and results

A total of 133 patients (66 ± 10 years, 60% male) with symptomatic persistent AF, who were scheduled for PVI using the second-generation CB were enrolled. Follow-up included 24 h Holter recording at 3, 6 and 12 months. Any documented episode of ATA lasting more than 30 s was considered as a recurrent arrhythmic event. All targeted veins were isolated (100%). Phrenic nerve palsy with recovery during follow-up occurred in six patients (4.5%), no patient experienced tamponade or a cerebrovascular event. During 12.6 ± 5.4 months of follow-up, 89/133 (67%) patients were free of ATA recurrences. Multivariable analysis revealed recurrence in the blanking period (HR 11.46, 0.95 CI 3.92–33.49, p < 0.001), presence of cardiomyopathy (HR 2.75, 0.95 CI 1.09–6.96, p = 0.032) and PV abnormality (HR 3.56, 0.95 CI 1.21–10.43, p = 0.021) as predictors for late recurrence.

Conclusion

In patients with persistent AF, second-generation cryoballoon use is associated with an excellent safety profile and favorable outcomes. Arrhythmia recurrence during the blanking period, presence of cardiomyopathy and PV abnormality were independent predictors of long-term AF recurrence.

Paulus Kirchhof, Authors/Task Force Members; Stefano Benussi, Authors/Task Force Members; Dipak Kotecha, Authors/Task Force Members; Anders Ahlsson, Authors/Task Force Members; Dan Atar, Authors/Task Force Members; Barbara Casadei, Authors/Task Force Members; Manuel Castella, Authors/Task Force Members; Hans-Christoph Diener, Authors/Task Force Members; Hein Heidbuchel, Authors/Task Force Members; Jeroen Hendriks, Authors/Task Force Members; Gerhard Hindricks, Authors/Task Force Members; Antonis S. Manolis, Authors/Task Force Members; Jonas Oldgren, Authors/Task Force Members; Bogdan Alexandru Popescu, Authors/Task Force Members; Ulrich Schotten, Authors/Task Force Members; Bart Van Putte, Authors/Task Force Members; Panagiotis Vardas, Authors/Task Force Members; Stefan Agewall, Document Reviewers; John Camm, Document Reviewers; Gonzalo Baron Esquivias, Document Reviewers; Werner Budts, Document Reviewers; Scipione Carerj, Document Reviewers; Filip Casselman, Document Reviewers; Antonio Coca, Document Reviewers; Raffaele De Caterina, Document Reviewers; Spiridon Deftereos, Document Reviewers; Dobromir Dobrev, Document Reviewers; José M. Ferro, Document Reviewers; Gerasimos Filippatos, Document Reviewers; Donna Fitzsimons, Document Reviewers; Bulent Gorenek, Document Reviewers; Maxine Guenoun, Document Reviewers; Stefan H. Hohnloser, Document Reviewers; Philippe Kolh, Document Reviewers; Gregory Y. H. Lip, Document Reviewers; Athanasios Manolis, Document Reviewers; John McMurray, Document Reviewers; Piotr Ponikowski, Document Reviewers; Raphael Rosenhek, Document Reviewers; Frank Ruschitzka, Document Reviewers; Irina Savelieva, Document Reviewers; Sanjay Sharma, Document Reviewers; Piotr Suwalski, Document Reviewers; Juan Luis Tamargo, Document Reviewers; Clare J. Taylor, Document Reviewers; Isabelle C. Van Gelder, Document Reviewers; Adriaan A. Voors, Document Reviewers; Stephan Windecker, Document Reviewers; Jose Luis Zamorano, Document Reviewers; Katja Zeppenfeld, Document Reviewers; 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37(38):2893–2962

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Titel: Safety and efficacy of persistent atrial fibrillation ablation using the second-generation cryoballoon
verfasst von: Kivanc Yalin
Amr Abdin
Evgeny Lyan
Noureddin Sawan
Spyridon Liosis
Christian Elsner
Alexander Jobs
Ben Brüggemann
Jelena Koester
Ingo Eitel
Charlotte Eitel
Roland Richard Tilz
Publikationsdatum: 28.02.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 7/2018
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1219-1

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Safety and efficacy of persistent atrial fibrillation ablation using the second-generation cryoballoon