One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation
Open Access
- 15 August 2008
- journal article
- clinical trial
- Published by Oxford University Press (OUP) in EP Europace
- Vol. 10 (11), 1271-1276
- https://doi.org/10.1093/europace/eun218
Abstract
Pulmonary vein isolation (PVI) with cryoenergy delivered through a balloon is a new approach in the treatment of atrial fibrillation (AF), but long-term follow-up is lacking. The aim of this study was to provide insight in the success rate and the incidence of recurrences. Patients with symptomatic AF despite anti-arrhythmic drugs (AADs) were treated with cryoballoon PVI. Daily transtelephonic ECG monitoring, 24 h Holter-ECG, and an arrhythmia-focused questionnaire were used to document AF. One hundred and forty-one patients completed a follow-up of 457 ± 252 days. Before ablation, Holter-ECG showed AF in 45%, including 16% continuous AF throughout the recording. Event recording revealed a median AF burden of 26%. The questionnaire showed a median of weekly AF complaints lasting for hours. All but one patient had successful PVI with a single procedure. After ablation, AF (defined as lasting for more than 30 s) was seen in 11% of Holter-ECGs, with 1% continuous AF. The event recording showed an AF burden of 9%. The median patient reported no more AF-related symptoms. Recurrence during the first 3 months was predictive for later recurrence. A second procedure was performed in 24 patients. The freedom of AF was 59% without AADs after 1,2 procedures. Four right phrenic nerve paralyses occurred, all resolving within 6 months. No PV stenoses were observed. Pulmonary vein isolation with a cryothermal balloon is an effective treatment for paroxysmal AF, resulting in a clinical success rate comparable to studies involving radiofrequency ablation. Temporary right phrenic nerve paralysis is the most important complication.Keywords
This publication has 18 references indexed in Scilit:
- HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up: A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation. Developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS); in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Endorsed and Approved by the governing bodies of the American College of Cardiology, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, and the Heart Rhythm SocietyHeart Rhythm, 2007
- Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-term outcomeEuropean Heart Journal, 2007
- Pulmonary vein isolation by high-intensity focused ultrasound: First-in-man study with a steerable balloon catheterHeart Rhythm, 2007
- Cryoablation of the pulmonary veins using a novel balloon catheterJournal of Interventional Cardiac Electrophysiology, 2006
- Targets and endpoints in ablation therapy for atrial fibrillation in the light of pathophysiological mechanismsJournal of Interventional Cardiac Electrophysiology, 2006
- Efficacy and Safety of Circumferential Pulmonary Vein Isolation Using a Novel Cryothermal Balloon Ablation SystemJournal of the American College of Cardiology, 2005
- Ablation of Atrial-Ventricular Junction Tissues via the Coronary Sinus Using Cryo Balloon TechnologyJournal of Interventional Cardiac Electrophysiology, 2005
- The safety and efficacy of multiple consecutive cryo lesions in canine pulmonary veins-left atrial junctionHeart Rhythm, 2004
- Pulmonary vein isolation using transvenous catheter cryoablation for treatment of atrial fibrillation without risk of pulmonary vein stenosisJournal of the American College of Cardiology, 2003
- First Human Experience With Pulmonary Vein Isolation Using a Through-the-Balloon Circumferential Ultrasound Ablation System for Recurrent Atrial FibrillationCirculation, 2000