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Journal of Interventional Cardiac Electrophysiology

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Open Access 12-04-2022 | Obesity

Procedural and outcome impact of obesity in cryoballoon versus radiofrequency pulmonary vein isolation in atrial fibrillation patients

Authors: Cornelia Scheurlen, Jan-Hendrik van den Bruck, Karlo Filipovic, Jonas Wörmann, Zeynep Arica, Susanne Erlhöfer, Sebastian Dittrich, Jordi Heijman, Jakob Lüker, Daniel Steven, Arian Sultan

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 2/2022

Abstract

Purpose

Cryoballoon (CB) ablation and radiofrequency (RF) ablation are the most common techniques for pulmonary vein isolation (PVI) in patients with symptomatic atrial fibrillation (AF). An increasing number of patients undergoing PVI are obese.

To address the paucity of data on outcomes of CB- vs. RF-based PVI in relation to body mass index (BMI) of AF patients.

Methods

All patients undergoing de novo PVI between 01/2018 and 08/2019 at University Hospital Cologne were included in this retrospective analysis. Patients of each group (CB-PVI vs. RF-PVI) were analyzed based on their BMI. Hereafter, procedural characteristics and AF recurrence rate were compared regarding different BMI groups.

Results

A total of 526 patients (62% male, 65±11 years) underwent successful de novo PVI (320 CB and 206 RF). In obese patients, two differences in procedural characteristics were noted: A significantly increased contrast medium volume in CB group and a lower fluoroscopy dose in RF group: contrast medium: CB 50 [40-80] vs. RF 20 [20-30], p<0.001; fluoroscopy dose: CB 392.4 [197.9-995.9] vs. RF 282.5 [139.8-507.2], p<0.001. The complication rate was equal throughout all BMI groups, regardless of CB or RF usage. For obese patients, a trend toward a higher AF recurrence rate was revealed after RF-PVI as compared to CB-PVI. In line with previous studies, the overall procedure time was significantly shorter with CB-PVI regardless of BMI.

Conclusion

For obese patients, CB-PVI is similarly safe and effective as RF-PVI. The significantly shorter procedure time for CB-PVI may minimize potential obesity-related complications. However, the lower contrast medium quantity and fluoroscopy dose in RF-PVI must be considered. AF recurrence rates were comparable between CB-PVI and RF-PVI.

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Title: Procedural and outcome impact of obesity in cryoballoon versus radiofrequency pulmonary vein isolation in atrial fibrillation patients
Authors: Cornelia Scheurlen
Jan-Hendrik van den Bruck
Karlo Filipovic
Jonas Wörmann
Zeynep Arica
Susanne Erlhöfer
Sebastian Dittrich
Jordi Heijman
Jakob Lüker
Daniel Steven
Arian Sultan
Publication date: 12-04-2022
Publisher: Springer US
Keywords: Obesity
Obesity
Atrial Fibrillation
Published in: Journal of Interventional Cardiac Electrophysiology / Issue 2/2022
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-022-01210-3

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