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Long-term outcome after second-generation cryoballoon ablation for paroxysmal atrial fibrillation - a 3-years follow-up

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Abstract

Background

The second-generation cryoballoon (cryoballoon Advance; CB-A) offers excellent outcomes on the mid-term follow-up. To the best of our knowledge, little is known regarding the long-term outcome after CB-A ablation for paroxysmal atrial fibrillation (AF).

Objective

The aim of the study was to evaluate the freedom from recurrence of AF during a 3-year follow-up period, among consecutive patients having undergone pulmonary vein isolation (PVI) with the CB-A for paroxysmal AF (PAF).

Methods

Consecutive patients with drug-resistant PAF who underwent PVI using CB-A as an index procedure formed the study group. Patients were evaluated with holter ECG recordings at 1, 3, 6 and 12 months and subsequent follow-up was biannual or based on the clinical status and at the physician discretion.

Results

Seventy-six consecutive patients were enrolled. Of these patients, 6 were excluded because of lack of long-term follow-up. A total of 70 patients [44 male (63%); mean age 57.9 ± 14.5 years] with a mean follow-up of 38.0 ± 7.4 months were finally included. In total, 278 PVs were depicted on the pre-procedural CT scan. All PVs (100%) could be isolated with the CB-A only. The freedom from AF without antiarrhythmic drug (AADs) after a single procedure was 71.5% of patients at a mean 38.0 ± 7.4 months follow-up. If including repeat procedures, 80% of the patients were free from AF recurrence after 1.11 ± 0.32 procedures without AADs.

Conclusion

The second-generation cryoballoon offers long-term freedom from PAF in 71.5% of treated patients with a single procedure without AADs on a 3-year follow-up period.

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Author notes

    Authors and Affiliations

    1. Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 101 Laarbeeklaan, 1090, Brussels, Belgium

      Ken Takarada, Ingrid Overeinder, Carlo de Asmundis, Erwin Stroker, Giacomo Mugnai, Valentina de Regibus, Darragh Moran, Hugo Coutino-Moreno, Juan-Pablo Abugattas, Rajin Choudhury, Diego Ruggiero, Pedro Brugada & Gian-Battista Chierchia

    2. Cliniques de l’Europe, Bruxelles, Belgium

      Gaetano Paparella

    3. Villa Maria Cecilia Hospital, GVM, Cotignola, Italy

      Saverio Iacopino

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    1. Ken Takarada
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    2. Ingrid Overeinder
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    Correspondence to Ken Takarada.

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    Funding

    No funding was used for this study.

    Conflict of interests

    Gian-Battista Chierchia, Carlo de Asmundis MD receive compensation for teaching purposes from AF Solutions, Medtronic. Gian-Battista Chierchia receives compensation for proctoring purposes from AF Solutions, Medtronic. Pedro Brugada has received speaker fees from Medtronic.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Informed consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Ken Takarada and Ingrid Overeinder contributed equally to this work.

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    Takarada, K., Overeinder, I., de Asmundis, C. et al. Long-term outcome after second-generation cryoballoon ablation for paroxysmal atrial fibrillation - a 3-years follow-up. J Interv Card Electrophysiol 49, 93–100 (2017). https://doi.org/10.1007/s10840-017-0237-7

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