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Repeat procedures after second-generation cryoballoon ablation as an index procedure for persistent atrial fibrillation: one-year follow-up

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Abstract

Purpose

Data indicate that the second-generation cryoballoon (Arctic Front Advance, Medtronic, Minnesota, USA) could be effective for persistent atrial fibrillation. However, electrophysiological findings and the midterm clinical outcome of repeat procedures following second-generation cryoballoon ablation are lacking.

Methods

Consecutive patients with drug-resistant persistent atrial fibrillation who underwent a repeat ablation due to arrhythmia recurrence following an index procedure with second-generation cryoballoon were retrospectively included in our analysis. A total of 24 patients were included. Twenty underwent repeat procedures because of atrial fibrillation or left atrial arrhythmias and four because of typical atrial flutter. Mean time to recurrence of atrial tachyarrhythmias was 6.6 ± 3 months. Mean redo procedural time was 122 ± 23 min.

Results

At a mean follow-up of 11.8 ± 6.5 months, 15 patients (75 %) did not experience recurrence of atrial arrhythmias. Of the five patients (25 %) who had recurrence of atrial tachyarrhythmia, four presented with persistent atrial fibrillation and one with a mitral isthmus-dependent flutter. Of note is that the four patients with typical flutter were free from atrial tachycardia recurrence after the redo procedure. Two patients (9 %) underwent a third procedure. Mean time to recurrence of atrial arrhythmias from the repeat procedure was 9 ± 1 months.

Conclusions

Our findings show that repeat ablation procedures following a second-generation cryoballoon ablation for persistent atrial fibrillation result in 75 % of freedom from any atrial tachycardia at 12 months follow-up. Of the recurrences, 63 % were due to new onset of atrial fibrillation and 37 % to organized tachycardias.

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Author notes

    Authors and Affiliations

    1. Heart Rhythm Management Centre, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium

      Hugo Enrique Coutiño, Carlo de Asmundis, Giacomo Mugnai, Darragh Moran, Valentina De Regibus, Erwin Ströker, Ken Takarada, Diego Ruggiero, Rajin Choudhury, Stefan Beckers, Carla Van Gompel, Jan Poelaert, Pedro Brugada & Gian-Battista Chierchia

    2. Cardiac Electrophysiology Unit, Villa Maria Cecilia Hospital, GVM, Cotignola, Italy

      Saverio Iacopino & Pasquale Filannino

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    1. Hugo Enrique Coutiño
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    2. Carlo de Asmundis
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    Corresponding author

    Correspondence to Gian-Battista Chierchia.

    Additional information

    Hugo Enrique Coutiño and Carlo de Asmundis contributed equally to this work.

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    Coutiño, H.E., de Asmundis, C., Mugnai, G. et al. Repeat procedures after second-generation cryoballoon ablation as an index procedure for persistent atrial fibrillation: one-year follow-up. J Interv Card Electrophysiol 47, 365–371 (2016). https://doi.org/10.1007/s10840-016-0179-5

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    • DOI: https://doi.org/10.1007/s10840-016-0179-5

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