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Decreasing time between first diagnosis of paroxysmal atrial fibrillation and cryoballoon ablation positively affects long-term consequences

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Abstract

Background

Patients with atrial fibrillation (AF) usually experience a worsening of their AF burden over time. We aimed to investigate timing of pulmonary vein isolation (PVI) by cryoballoon (CB-2) after the first clinical diagnosis of AF on ablation-related outcomes.

Methods

A total of 132 consecutive patients with paroxysmal AF undergoing PVI by CB-2 were included in the study. The patients were retrospectively sorted into two groups to evaluate differences in AF recurrence risk associated with early ablation (n = 89), defined as within 365 days of first AF diagnosis, and late ablation (n = 365), defined as > 365 days after first AF diagnosis. AF-free survival during follow-up was compared between groups.

Results

Although mean procedure times were comparable between groups, mean fluoroscopy times were lower in the early ablation group. For the whole study group, median (interquartile range) time from AF diagnosis to first ablation was 4.0 (2.0–11.3) months [3.0 (1.0–4.0) vs 14.0 (12.0–22.5) months in the early and late ablation groups, respectively]. Median follow-up for the whole population was 12.0 (12.0–18.0) months, and after the blanking period, 14 (10.6%) patients had arrhythmia recurrence (2 in the early and 12 in the late ablation groups). In the univariable Cox regression analysis and propensity score adjusted penalized Cox regression analysis, there was a significant association between delay in ablation time and AF recurrence (unadjusted hazard ratio = 7.74, 95% CI 2.26–40.1, p < 0.001, adjusted hazard ratio = 7.50, 95% CI 2.23–38.6, p < 0.001).

Conclusion

Delays in treatment with CB-2 ablation may negatively affect AF-free survival rates among patients with paroxysmal AF.

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Authors and Affiliations

  1. Department of Cardiology, Diyarbakir Gazi Yasargil Training and Research Hospital, University of Health Sciences, Diyarbakir, Turkey

    Erkan Baysal, Metin Okşul & Cengiz Burak

  2. Department of Cardiology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Kivanc Yalin, Ali Ugur Soysal & Hakan Yalman

  3. Department of Cardiology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey

    Serdar Bozyel & Tumer Erdem Guler

  4. Department of Cardiology, Faculty of Medicine, Nisantası University, Istanbul, Turkey

    Halil Ibrahim Tanboga

  5. Department of Cardiology, Yeditepe University Hospital, 41500, Istanbul, Turkey

    Tolga Aksu

Authors
  1. Erkan Baysal
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  2. Metin Okşul
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  3. Cengiz Burak
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  4. Kivanc Yalin
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  5. Ali Ugur Soysal
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  6. Hakan Yalman
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  7. Serdar Bozyel
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  8. Tumer Erdem Guler
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  9. Halil Ibrahim Tanboga
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  10. Tolga Aksu
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Corresponding author

Correspondence to Tolga Aksu.

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Ethics approval

Ethical committees of the study sites approved the study.

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It has been waived due to retrospective design of the study.

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The authors declare no competing interests.

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Highlights

• The authors have evaluated the effect of early application of cryoballoon in treatment after the first clinical diagnosis of atrial fibrillation (AF) on AF recurrence.

• AF-free survival was higher in early intervention group compared to those with a delay in treatment.

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Baysal, E., Okşul, M., Burak, C. et al. Decreasing time between first diagnosis of paroxysmal atrial fibrillation and cryoballoon ablation positively affects long-term consequences. J Interv Card Electrophysiol 65, 365–372 (2022). https://doi.org/10.1007/s10840-022-01167-3

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  • DOI: https://doi.org/10.1007/s10840-022-01167-3

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