AI Article Synopsis
- The study investigated long-term thromboembolic events (TEs) following cryoballoon pulmonary vein isolation (cryo-PVI) for atrial fibrillation (AF), finding that TEs occurred at a low rate of 0.53% per year.
- It analyzed data from 450 patients over a mean follow-up of 30 months, revealing that most patients who experienced TEs had a risk indicative of the need for long-term anticoagulation according to their CHADS-VASc scores.
- Ultimately, the CHADS-VASc Score was identified as the only significant predictor of TEs in this patient population.
Article Abstract
Background: Long-term outcomes in terms of thromboembolic events (TEs) are poorly described after cryoballoon pulmonary vein isolation (cryo-PVI) for atrial fibrillation (AF). We evaluated the long-term incidence and predictive factors of TE after cryo-PVI.
Methods: All consecutive patients who underwent cryo-PVI for paroxysmal or persistent AF between November 2012 and October 2017 were included. They were prospectively followed for at least 12 months in the ablation center and then by their cardiologist. Data on all ischemic events (stroke, transient ischemic attack (TIA), systemic embolism) were collected.
Results: In total, 450 patients (78% men, median age 61 years) were included. The mean CHADS-VASc score was 1.6 ± 1.3 and 26 patients (6%) had a history of stroke/TIA before the procedure. OAT was discontinued for 75 patients (17%) after the procedure, among whom 50 (67%) had no indication for long-term anticoagulation. Six patients experienced an ischemic event, all considered as a TE: three strokes, two TIAs, and one acute lower-limb ischemia. The mean follow up was 30 months. Thus, the incidence of TE was 0.53%/year. Three of the six patients who experienced a TE had no recurrence of atrial arrhythmia documented before, at the time, or after the event. All patients who experienced a TE had a class I or class IIa indication for long-term anticoagulation. After multivariate analysis, the CHADS-VASc Score (p = .0005) was a predictor of TEs.
Conclusion: The long-term incidence of TEs after cryo-PVI was 0.53%/year. The CHADS-VASc Score was the only independent predictor of TEs.
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| http://dx.doi.org/10.1016/j.ijcard.2020.08.005 | DOI Listing |
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