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Long-term outcome of cryoballoon ablation versus radiofrequency ablation for focal atrial tachycardias originating from the pulmonary veins

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Abstract

Purpose

We aimed to investigate the characteristics of focal atrial tachycardias (ATs) arising from the pulmonary veins (PVs), as well as the safety and long-term efficacy of cryoballoon (CB) versus radiofrequency (RF) ablation in this population.

Methods

Eighty-three patients with ATs arising from PVs from a consecutive series of 487 patients who underwent CB and RF ablation were retrospectively reviewed. Patients who had a prior history of atrial fibrillation (AF) were excluded. The AT origin was confirmed during the conventional electrophysiological study and activation mapping. The ablation approach was at the discretion of the operators.

Results

Thirty-five patients were managed with focal ablation, 25 were ablated with unilateral PV isolation (PVI), and the remaining 23 were performed with CB ablation. All procedures were successfully ablated. There was no significant difference in procedure time between CB group and RF focal group (43.7 ± 11.8 min vs. 45.8 ± 11.2 min, P = 0.121), whereas the fluoroscopy time in CB group was longer than in RF PVI group (10.1 ± 2.5 min vs. 8.4 ± 2.8 min, P < 0.001). There was 1 recurrence in CB group, 4 recurrences of AT in RF focal group, and 2 recurrence in RF PVI group (P = 0.643). Repeat ablation was performed in 6 of 7 patients. Seventy-eight patients were available for long-term follow-up. At a mean of 5.4 ± 4.6-year follow-up, 77 of 78 patients were free from AT without antiarrhythmic medication after 1.1 ± 0.3 procedures. No patient had procedural complications and developed AF during the follow-up period.

Conclusions

CB ablation is an effective and safe tool to treat ATs originating from the PVs. The ATs originating from the PVs represent an isolated clinical process and are not likely to be the forerunner of a more diffuse process leading to the development of PV AF.

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Funding

This work was funded by a grant of the National Natural Science Foundation of China (#81670309).

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Authors and Affiliations

  1. State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, 100037, China

    Hui-Qiang Wei, Xiao-Gang Guo, Qi Sun, Bin Luo, Jian-Du Yang, Shu Zhang & Jian Ma

  2. Department of cardiology, Peking University Third Hospital, Beijing, China

    Gong-Bu Zhou

  3. Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China

    Xu Liu

Authors
  1. Hui-Qiang Wei
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  2. Xiao-Gang Guo
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  4. Qi Sun
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  5. Xu Liu
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  6. Bin Luo
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  7. Jian-Du Yang
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  8. Shu Zhang
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  9. Jian Ma
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Correspondence to Jian Ma.

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The research protocol used in this study was reviewed and approved by the institutional review board of the Fuwai Hospital.

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Wei, HQ., Guo, XG., Zhou, GB. et al. Long-term outcome of cryoballoon ablation versus radiofrequency ablation for focal atrial tachycardias originating from the pulmonary veins. J Interv Card Electrophysiol 56, 271–278 (2019). https://doi.org/10.1007/s10840-019-00507-0

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  • DOI: https://doi.org/10.1007/s10840-019-00507-0

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