Introduction: Cryoballoon ablation (CBA) has become a standard treatment for paroxysmal atrial fibrillation (PaAF) but limited data is available for outcomes in patients with persistent atrial fibrillation (PeAF). Methods: We analyzed the first 944 patients included in the Spanish Prospective Multi-center Observation Post-market Registry to compare characteristics and outcomes of patients undergoing CBA for PeAF versus PaAF. Results: A total of 944 patients (57.8 ± 10.4 years; 70.1% male) with AF (27.9% persistent) were prospectively included from 25 centers. PeAF patients were more likely to have structural heart disease (67.7 vs. 11.4%; p < 0.001) and left atrium dilation (72.6 vs. 43.3%; p < 0.001). CBA of PeAF was less likely to be performed under general anesthesia (10.7 vs. 22.2%; p < 0.001), with an arterial line (32.2 vs. 44.6%; p < 0.001) and assisted transeptal puncture (11.9 vs. 17.9%; p = 0.025). During an application, PeAF patients had a longer time to −30 °C (35.91 ± 14.20 vs. 34.93 ± 12.87 s; p = 0.021) and a colder balloon nadir temperature during vein isolation (−35.04 ± 9.58 vs. −33.61 ± 10.32 °C; p = 0.004), but received fewer bonus freeze applications (30.7 vs. 41.1%; p < 0.001). There were no differences in acute pulmonary vein isolation and procedure-related complications. Overall, 76.7% of patients were free from AF recurrences at 15-month follow-up (78.9% in PaAF vs. 70.9% in PeAF; p = 0.09). Conclusions: Patients with PeAF have a more diseased substrate, and CBA procedures performed in such patients were more simplified, although longer/colder freeze applications were often applied. The acute efficacy/safety profile of CBA was similar between PaAF and PeAF patients, but long-term results were better in PaAF patients.
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http://dx.doi.org/10.3390/jcm11051166 | DOI Listing |
Cureus
December 2024
Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, ITA.
This post-market clinical follow-up (PMCF) study evaluates the clinical effectiveness and safety of the external radio electric reprogramming for atrial fibrillation (EX-RER AF) protocol, a non-invasive regenerative medicine approach utilizing radio electric asymmetric conveyer (REAC) technology for managing paroxysmal atrial fibrillation (PAF). Administered with the REAC BENE mod 110 device (ASMED, Scandicci, Italy), the treatment involves a standardized procedure, with the asymmetric conveyor probe (ACP) positioned in the precordial area and fixed, unmodifiable parameters ensuring consistency and reproducibility. During a 36-month post-market clinical follow-up (PMCF), 20 patients with prior diagnoses of PAF underwent the protocol.
View Article and Find Full Text PDFInt J Cardiol Congenit Heart Dis
June 2023
Bristol Heart Institute, Terrell Street, Bristol, BS2 8ED, UK.
Aims: To define the cohort of adult congenital heart disease (ACHD) patients undergoing catheter ablation for supraventricular arrhythmia in a large tertiary centre, characterise outcomes, and determine factors associated with arrhythmia recurrence.
Methods: Single centre retrospective study of all catheter ablations for atrial arrhythmias in ACHD patients between September 2014 and October 2021. Patients were identified using a field search through a centralised database.
Int J Cardiol Congenit Heart Dis
June 2023
Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
The number of women with congenital heart disease (CHD) surviving to childbearing age is continuously growing. Although most pregnancies in this patient-population are well tolerated, there is a significant risk of potentially fatal complications. We describe a case of a previously completely asymptomatic patient who was diagnosed late during pregnancy with an inferior sinus venosus type atrial septal defect (ISV-ASD) and anomalous connection of all right pulmonary veins (PAPVC) who presented a cardiac arrest with ventricular fibrillation the day after delivery.
View Article and Find Full Text PDFInt J Cardiol Congenit Heart Dis
June 2023
Adult Congenital Heart Disease Unit, Department of Cardiology, Monaldi Hospital, Naples, Italy.
Thanks to advances in both medical care and surgical techniques, over recent years, survival for patients with congenital heart disease (CHD) has increased significantly, with about 90% of patients now reaching adulthood. However, as CHD patients grow older, their relative risk of developing coronary artery disease (CAD) increases. Moreover, it has been demonstrated that the majority of adult congenital heart disease (ACHD) patients has at least one cardiovascular risk factor.
View Article and Find Full Text PDFBiologics
December 2024
Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Introduction: Atrial fibrillation (AFib) is a common disorder featured by an irregular and fast heartbeat. The etiology of AFib is complex and involves genetic and environmental factors. The rs2200733 single nucleotide polymorphism (SNP) is located in close proximity to the promoter of paired-like homeodomain transcription factor 2 (PITX2) which plays a role in heart development.
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