AI Article Synopsis
- Cryoballoon pulmonary vein isolation (PVI) is gaining popularity for treating persistent atrial fibrillation (AF), and this study analyzed its effectiveness and recurrence rates after the procedure.
- Out of 399 patients treated, 90% completed a 12-month follow-up, revealing a 2-year freedom from arrhythmia at 51% for persistent AF and 27% for long-standing persistent AF.
- Key predictors for recurrence included long-standing persistent AF and the size of the left atrial area/volume, with complications being rare (only a few cases of serious side effects).
Article Abstract
Cryoballoon pulmonary vein isolation (PVI) for persistent atrial fibrillation (AF) ablation is an increasingly used strategy. We aimed to determine the results and predictors of arrhythmia recurrence after a single procedure of cryoballoon PVI for patients with persistent and long-standing persistent AF. We included all consecutive patients who underwent cryoballoon PVI for the treatment of persistent symptomatic drug-refractory AF since 2012. All patients were prospectively followed to detect the recurrence of atrial tachyarrhythmia (ATa). Predictors of recurrence were assessed. Cryoballoon PVI was performed on 399 patients with persistent AF, among whom 52 (13%) had long-standing persistent AF. Patients with long-standing persistent AF had a significantly larger left atrium than those with persistent AF. A 28-mm cryoballoon was used for 322 patients (93%). In total, 359 patients (90%) completed the 12-month follow-up visit and the median follow-up was 24 months (interquartile range 43 to 13). The 2-year probability of freedom from ATa recurrence was 51% for persistent AF and 27% for long-standing persistent AF. Long-standing persistent AF and left atrial area/volume were independent predictors of ATa recurrence. Ten patients (2.5%) experienced phrenic nerve palsy, 1 tamponade (0.25%), 2 stroke (0.5%), 2 pericardial effusions (0.5%), and 5 vascular complications (1.25%). In conclusion, 2-year ATa-free survival rates were 51 and 27% for persistent and long-standing persistent AF patients, respectively. Complications were rare. Long-standing persistent AF and left-atrial area/volume were predictors of recurrence.
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| http://dx.doi.org/10.1016/j.amjcard.2021.07.052 | DOI Listing |
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