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Published in: Clinical Research in Cardiology 7/2018

01-07-2018 | Original Paper

Safety and efficacy of persistent atrial fibrillation ablation using the second-generation cryoballoon

Authors: Kivanc Yalin, Amr Abdin, Evgeny Lyan, Noureddin Sawan, Spyridon Liosis, Christian Elsner, Alexander Jobs, Ben Brüggemann, Jelena Koester, Ingo Eitel, Charlotte Eitel, Roland Richard Tilz

Published in: Clinical Research in Cardiology | Issue 7/2018

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Abstract

Background

The second-generation cryoballoon (CB) is increasingly used for treatment of persistent atrial fibrillation (AF). Data regarding the clinical outcome and mechanism of arrhythmia recurrence following persistent AF ablation using CB is sparse. In this study, we aimed to assess the efficacy of CB and mechanisms of atrial tachyarrhythmia (ATA) recurrence in patients with persistent AF.

Methods and results

A total of 133 patients (66 ± 10 years, 60% male) with symptomatic persistent AF, who were scheduled for PVI using the second-generation CB were enrolled. Follow-up included 24 h Holter recording at 3, 6 and 12 months. Any documented episode of ATA lasting more than 30 s was considered as a recurrent arrhythmic event. All targeted veins were isolated (100%). Phrenic nerve palsy with recovery during follow-up occurred in six patients (4.5%), no patient experienced tamponade or a cerebrovascular event. During 12.6 ± 5.4 months of follow-up, 89/133 (67%) patients were free of ATA recurrences. Multivariable analysis revealed recurrence in the blanking period (HR 11.46, 0.95 CI 3.92–33.49, p < 0.001), presence of cardiomyopathy (HR 2.75, 0.95 CI 1.09–6.96, p = 0.032) and PV abnormality (HR 3.56, 0.95 CI 1.21–10.43, p = 0.021) as predictors for late recurrence.

Conclusion

In patients with persistent AF, second-generation cryoballoon use is associated with an excellent safety profile and favorable outcomes. Arrhythmia recurrence during the blanking period, presence of cardiomyopathy and PV abnormality were independent predictors of long-term AF recurrence.
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Metadata
Title
Safety and efficacy of persistent atrial fibrillation ablation using the second-generation cryoballoon
Authors
Kivanc Yalin
Amr Abdin
Evgeny Lyan
Noureddin Sawan
Spyridon Liosis
Christian Elsner
Alexander Jobs
Ben Brüggemann
Jelena Koester
Ingo Eitel
Charlotte Eitel
Roland Richard Tilz
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Research in Cardiology / Issue 7/2018
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-018-1219-1

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