Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation: Procedural Differences and Results from the Spanish Registry (RECABA)
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2022
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| contents | <p>Abstract: Introduction: Cryoballoon ablation (CBA) has become a standard treatment for paroxysmal<br>atrial fibrillation (PaAF) but limited data is available for outcomes in patients with persistent atrial<br>fibrillation (PeAF). Methods: We analyzed the first 944 patients included in the Spanish Prospective<br>Multi-center Observation Post-market Registry to compare characteristics and outcomes of patients<br>undergoing CBA for PeAF versus PaAF. Results: A total of 944 patients (57.8 ± 10.4 years; 70.1%<br>male) with AF (27.9% persistent) were prospectively included from 25 centers. PeAF patients were<br>more likely to have structural heart disease (67.7 vs. 11.4%; p < 0.001) and left atrium dilation<br>(72.6 vs. 43.3%; p < 0.001). CBA of PeAF was less likely to be performed under general anesthesia<br>(10.7 vs. 22.2%; p < 0.001), with an arterial line (32.2 vs. 44.6%; p < 0.001) and assisted transeptal<br>puncture (11.9 vs. 17.9%; p = 0.025). During an application, PeAF patients had a longer time to<br>−30 ◦C (35.91 ± 14.20 vs. 34.93 ± 12.87 s; p = 0.021) and a colder balloon nadir temperature during<br>vein isolation (−35.04 ± 9.58 vs. −33.61 ± 10.32 ◦C; p = 0.004), but received fewer bonus freeze<br>applications (30.7 vs. 41.1%; p < 0.001). There were no differences in acute pulmonary vein isolation<br>and procedure-related complications. Overall, 76.7% of patients were free from AF recurrences<br>at 15-month follow-up (78.9% in PaAF vs. 70.9% in PeAF; p = 0.09). Conclusions: Patients with<br>PeAF have a more diseased substrate, and CBA procedures performed in such patients were more<br>simplified, although longer/colder freeze applications were often applied. The acute efficacy/safety<br>profile of CBA was similar between PaAF and PeAF patients, but long-term results were better in<br>PaAF patients.</p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_3390_jcm11051166 |
| institution | Zenodo |
| language | |
| publishDate | 2022 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation: Procedural Differences and Results from the Spanish Registry (RECABA) Je <p>Abstract: Introduction: Cryoballoon ablation (CBA) has become a standard treatment for paroxysmal<br>atrial fibrillation (PaAF) but limited data is available for outcomes in patients with persistent atrial<br>fibrillation (PeAF). Methods: We analyzed the first 944 patients included in the Spanish Prospective<br>Multi-center Observation Post-market Registry to compare characteristics and outcomes of patients<br>undergoing CBA for PeAF versus PaAF. Results: A total of 944 patients (57.8 ± 10.4 years; 70.1%<br>male) with AF (27.9% persistent) were prospectively included from 25 centers. PeAF patients were<br>more likely to have structural heart disease (67.7 vs. 11.4%; p < 0.001) and left atrium dilation<br>(72.6 vs. 43.3%; p < 0.001). CBA of PeAF was less likely to be performed under general anesthesia<br>(10.7 vs. 22.2%; p < 0.001), with an arterial line (32.2 vs. 44.6%; p < 0.001) and assisted transeptal<br>puncture (11.9 vs. 17.9%; p = 0.025). During an application, PeAF patients had a longer time to<br>−30 ◦C (35.91 ± 14.20 vs. 34.93 ± 12.87 s; p = 0.021) and a colder balloon nadir temperature during<br>vein isolation (−35.04 ± 9.58 vs. −33.61 ± 10.32 ◦C; p = 0.004), but received fewer bonus freeze<br>applications (30.7 vs. 41.1%; p < 0.001). There were no differences in acute pulmonary vein isolation<br>and procedure-related complications. Overall, 76.7% of patients were free from AF recurrences<br>at 15-month follow-up (78.9% in PaAF vs. 70.9% in PeAF; p = 0.09). Conclusions: Patients with<br>PeAF have a more diseased substrate, and CBA procedures performed in such patients were more<br>simplified, although longer/colder freeze applications were often applied. The acute efficacy/safety<br>profile of CBA was similar between PaAF and PeAF patients, but long-term results were better in<br>PaAF patients.</p> |
| title | Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation: Procedural Differences and Results from the Spanish Registry (RECABA) |
| url | https://doi.org/10.3390/jcm11051166 |