Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation: Procedural Differences and Results from the Spanish Registry (RECABA)
Year: 2022
Type: article
Study design: Observational Study
Abstract: 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.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm11051166
Authors: Ermengol Valles, Jesus Jimenez, Julio Martí-Almor, Jorge Toquero, Jose Ormaetxe, Alberto Barrera-Cordero, Arcadi García-Alberola, Jose Manuel Rubio, PABLO MORIÑA-VÁZQUEZ, Carlos Grande, Maria Fe Arcocha, Rafael Peinado, Rocio Cozar, Julio Salvador Hernandez Afonso, Luisa Perez Alvarez, Larraitz Gaztañaga, Angel Ferrero, Ricardo Ruiz Granell, Roger Villuendas, jesus martinez-alday
Institutions: Universitat Autònoma de Barcelona, Hospital Del Mar, Hospital del Mar Research Institute, Hospital Universitario Puerta de Hierro Majadahonda, Hospital de Basurto, Hospital Clínico Universitario Virgen de la Victoria, Hospital Universitario Virgen de la Arrixaca, Hospital Universitario Fundación Jiménez Díaz, Hospital Juan Ramón Jiménez, Hospital Universitario Son Espases, Hospital Universitario Araba, Hospital Universitario La Paz, Hospital Universitario Virgen Macarena, Hospital Universitario Nuestra Señora de Candelaria, Complexo Hospitalario Universitario A Coruña, Clinic IMQ Zorrotzaurre, Hospital Clínico Universitario de Valencia, Hospital Universitari Germans Trias i Pujol
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,513
OpenAlex ID: W4221049577