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Open Access 01-12-2021 | Antiarrhythmic Drugs | Research

The predictive role of early recurrences of atrial arrhythmias after pulmonary vein cryoballoon ablation. Is blanking period an outdated concept? Insights from 12-month continuous cardiac monitoring

Authors: Karapet V. Davtyan, Arpi H. Topchyan, Hakob A. Brutyan, Elena N. Kalemberg, Maria S. Kharlap, Georgiy Yu. Simonyan, Andrey A. Kalemberg, Maria V. Kuznetsova

Published in: BMC Cardiovascular Disorders | Issue 1/2021

Abstract

Background

Early recurrences of atrial arrhythmias (ERAA) after atrial fibrillation (AF) catheter ablation do not predict procedural failure. A well-demarcated homogeneous lesion delivered by cryoballoon is less arrhythmogenic, and the recommended three-months blanking period may not refer to cryoballoon ablation (CBA).

Objective

We aimed to evaluate the predictive role of ERAA after second-generation CBA using an implantable loop recorder.

Methods

This prospective observational study enrolled 100 patients (58 males, median age 58) with paroxysmal/persistent AF undergoing pulmonary vein (PV) CBA using second-generation cryoballoon with simultaneous ECG loop recorder implantation. The duration of follow-up was 12 months, with scheduled visits at 3, 6 and 12 months.

Results

99 patients from 100 completed the 12-month follow-up period. ERAA occurred in 31.3 % of patients. 83.9 % of patients with ERAA also developed late recurrences. The 12-month freedom from AF in patients with ERAA was significantly lower than in those without ERAA (p < 0.0001). Non-paroxysmal AF and longer arrhythmia history were associated with increased risk of both early (HR 3.27; 95 % CI 1.32–8.08; p = 0.010 and HR 1.0147; 95 % CI 1.008–1.086; p = 0.015, respectively) and late recurrences (HR 3.89; 95 % CI 1.67–9.04; p = 0.002 and HR 1.0142; 95 % CI 1.007–1.078; p = 0.019, respectively) of AF. ERAA were another predictor for procedural failure (HR 15.2; 95 % CI (6.42–35.99; p = 0.019).

Conclusions

ERAA occurred in the third of the patients after PV second-generation CBA and are strongly associated with procedural failure. Longer duration of AF history and persistent AF are independent predictors of AF’s early and late recurrence.

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Title: The predictive role of early recurrences of atrial arrhythmias after pulmonary vein cryoballoon ablation. Is blanking period an outdated concept? Insights from 12-month continuous cardiac monitoring
Authors: Karapet V. Davtyan
Arpi H. Topchyan
Hakob A. Brutyan
Elena N. Kalemberg
Maria S. Kharlap
Georgiy Yu. Simonyan
Andrey A. Kalemberg
Maria V. Kuznetsova
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Antiarrhythmic Drugs
Atrial Fibrillation
Published in: BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI: https://doi.org/10.1186/s12872-021-02300-2

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The predictive role of early recurrences of atrial arrhythmias after pulmonary vein cryoballoon ablation. Is blanking period an outdated concept? Insights from 12-month continuous cardiac monitoring

Abstract

Background

Objective

Methods

Results

Conclusions

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