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Long-term clinical outcomes after single freeze cryoballoon ablation for paroxysmal atrial fibrillation: a 5-year follow-up

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Abstract

Background

The second-generation cryoballoon ablation (CB-A) has been proven to be safe and effective for pulmonary vein (PV) isolation. Little is known regarding the long-term outcome following CB-A ablation for paroxysmal atrial fibrillation (AF). The aim of the study was to evaluate the freedom from atrial arrhythmias during a 5-year follow-up period among consecutive patients having undergone PV isolation with the CB-A for paroxysmal AF

Methods and results

A total of 208 consecutive patients having undergone index PV isolation using CB-A (138 males, 66%; mean age 59.0 ± 12.6 years) were included in our retrospective analysis. Follow-up was based on outpatient clinic visits including Holter electrocardiograms. Recurrence of atrial tachyarrhythmias was defined as a symptomatic or documented episode of > 30 s. At a median follow-up of 62 months, freedom from atrial arrhythmias after a single procedure was achieved in 57.2% of patients. Multivariate analysis demonstrated that obesity, left atrial diameter, and duration of symptoms before AF ablation were independent predictors of ATas recurrences. Major complications occurred in 2.4% of patients.

Conclusions

The present study found a 5-year single-procedure success rate of 57.2% following CB-A ablation procedure. Obesity, higher LA dimensions, and longer duration of symptoms before ablation independently predicted the outcome.

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Authors and Affiliations

  1. Heart Rhythm Management Center, Universitair Ziekenhuis Brussel, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium

    Giacomo Mugnai, Gaetano Paparella, Ingrid Overeinder, Erwin Ströker, Juan Sieira, Antonio Bisignani, Saverio Iacopino, Serge Boveda, Stefan Beckers, Vincent Umbrain, Gezim Bala, Pedro Brugada, Carlo de Asmundis & Gian-Battista Chierchia

Authors
  1. Giacomo Mugnai
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  2. Gaetano Paparella
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  3. Ingrid Overeinder
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  4. Erwin Ströker
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  5. Juan Sieira
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  6. Antonio Bisignani
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  7. Saverio Iacopino
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  8. Serge Boveda
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  9. Stefan Beckers
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  10. Vincent Umbrain
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  11. Gezim Bala
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  12. Pedro Brugada
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  13. Carlo de Asmundis
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  14. Gian-Battista Chierchia
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Corresponding author

Correspondence to Giacomo Mugnai.

Ethics declarations

The protocol was carried out in accordance with the ethical principles for medical research involving human subjects established by Helsinki’s declaration, protecting the privacy of all the participants as well as the confidentiality of their personal information.

Conflict of interest

GBC and CdA receive compensation for teaching purposes and proctoring from AF solutions, Medtronic. PB receives research grants on behalf of the centre from Biotronik, Medtronic, St Jude Medical, Sorin, Boston Scientific and speaker’s fees from Biosense-Webster, Biotronik, and Medtronic. CdA is consultant for Daiichi Sankyo. SB: consultant fees from Medtronic, Boston Scientific, Microport, and Zoll. GM received an educational grant from Medtronic for Postgraduate in Cardiac Electrophysiology and Pacing academic course.

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Mugnai, G., Paparella, G., Overeinder, I. et al. Long-term clinical outcomes after single freeze cryoballoon ablation for paroxysmal atrial fibrillation: a 5-year follow-up. J Interv Card Electrophysiol 61, 87–93 (2021). https://doi.org/10.1007/s10840-020-00788-w

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  • DOI: https://doi.org/10.1007/s10840-020-00788-w

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