Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation : Procedural Differences and Results from the Spanish Registry (RECABA)
Vallès, Ermengol (Institut Hospital del Mar d'Investigacions Mèdiques)
Jiménez, Jesús (Institut Hospital del Mar d'Investigacions Mèdiques)
Martí-Almor, Julio (Institut Hospital del Mar d'Investigacions Mèdiques)
Toquero, Jorge (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Ormaetxe, José Miguel (Hospital de Basurto)
Barrera, Alberto (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
García-Alberola, Arcadio (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Rubio, José Manuel (Hospital Universitario Fundación Jiménez Díaz)
Moriña, Pablo (Hospital Juan Ramón Jiménez (Huelva))
Grande, Carlos (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Fé Arcocha, Maria (Arabako Unibertsitate Ospitalea (Vitoria, País Basc))
Peinado, Rafael (Hospital Universitario La Paz (Madrid))
Cózar, Rocío (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Hernández, Julio (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Pérez-Alvarez, Luisa (Complejo Hospitalario Universitario de A Coruña)
Gaztañaga, Larraitz (Clínica IMQ Zorrotzaurre, 48014 Bilbao, Spain)
Ferrero-De Loma-Osorio, Angel (Hospital Clínic Universitari (València))
Ruiz-Granell, Ricardo (Hospital Clínic Universitari (València))
Villuendas-Sabaté, Roger (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martínez-Alday, Jesús Daniel (Clínica IMQ Zorrotzaurre)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	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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Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Persistent atrial fibrillation ; Cryoballoon procedure ; Registry
Publicat a:	Journal of clinical medicine, Vol. 11 (february 2022) , ISSN 2077-0383

DOI: 10.3390/jcm11051166
PMID: 35268259

12 p, 411.5 KB

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