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Paroxysmal atrial fibrillation recurrence after redo procedure-ablation modality impact

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Atrial fibrillation recurrence (AFR) is common after pulmonary vein isolation (PVI), and the rate does not differ between radiofrequency (RF) and cryoballoon (CB) ablation. The aim of this study was to assess the impact of the ablation modality used at the index PVI on the outcome after redo PVI in patients with paroxysmal AF.

Methods

In this prospective, single-center, non-randomized study, consecutive patients with paroxysmal AF who have undergone the index PVI with either RF ablation (RF group) or 2nd-generation CB (CB group) were included. The primary endpoint was freedom from recurrence of atrial arrhythmia lasting > 30 s.

Results

A total of 105 patients undergoing redo PVI for paroxysmal AF were included (median age 61 years; 24% female; left ventricular ejection fraction (LVEF) 57 ± 8%; left atrial volume index (LAVI) 34 ± 11 mm). Index PVI was done either with focal RF (n = 81) or with CB (n = 24) and redo PVI only with focal RF. Total procedure time (139 vs. 113 min, p = 0.10) and RF delivery time (1017 vs. 870 s, p = 0.33) of the redo PVI were not significantly different. After a median follow-up of 371 (185–470) days, there were no differences between the RF and CB groups regarding the AFR rate after the second PVI (24 vs. 23%, p = 0.89). The Kaplan-Meier analysis showed no difference between the groups regarding AFR freedom time (p = 0.81). In multivariable logistic regression, only coronary artery disease was identified as an independent long-term predictor of AFR (OR 4.15, 95% CI 1.17–14.71, p = 0.027).

Conclusions

The ablation modality used at the index PVI has no impact on long-term outcome after redo PVI in patients with paroxysmal AF.

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Authors and Affiliations

  1. Cardiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland

    Ivan Zeljkovic, Sven Knecht, Florian Spies, Tobias Reichlin, Stefan Osswald, Michael Kühne & Christian Sticherling

  2. Cardiovascular Research Institute Basel, Basel, Switzerland

    Sven Knecht, Florian Spies, Stefan Osswald, Michael Kühne & Christian Sticherling

  3. Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland

    Tobias Reichlin

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  1. Ivan Zeljkovic
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  2. Sven Knecht
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  3. Florian Spies
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Contributions

IZ: Concept/design, data analysis/interpretation, drafting article, critical revision of article, approval of article; SK: concept/design, data analysis/interpretation, drafting article, critical revision of article, approval of article, statistics; FS: data analysis/interpretation, drafting article, approval of article; TR: data analysis/interpretation, critical revision of article, approval of article; BS: data analysis/interpretation, critical revision of article, approval of article; SO: data analysis/interpretation, critical revision of article, approval of article; CS: concept/design, data analysis/interpretation, critical revision of article, approval of article; MK: concept/design, data analysis/interpretation, drafting article, critical revision of article, approval of article

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Correspondence to Ivan Zeljkovic.

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The authors declare that they have no conflict of interest.

Ethical approval

The Hospital Ethics Committee approved the study, which was conducted in accordance with the Declaration of Helsinki.

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Zeljkovic, I., Knecht, S., Spies, F. et al. Paroxysmal atrial fibrillation recurrence after redo procedure-ablation modality impact. J Interv Card Electrophysiol 57, 77–85 (2020). https://doi.org/10.1007/s10840-019-00694-w

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  • DOI: https://doi.org/10.1007/s10840-019-00694-w

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