Luigi Padeletti1,2, Antonio Curnis3, Claudio Tondo4, Maurizio Lunati5, Stefano Porcellini6, Roberto Verlato7, Luigi Sciarra8, Gaetano Senatore9, Domenico Catanzariti10, Loira Leoni11, Maurizio Landolina12, Pietro Delise13, Saverio Iacopino14, Paolo Pieragnoli15, Giuseppe Arena16. 1. University of Florence, Firenze, Italy. 2. IRCCS Multimedica, Milano, Italy. 3. Azienza Ospedaliera Spedali Civili, Brescia, Italy. 4. Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, University of Milan, Milano, Italy. 5. Ospedale Niguarda Ca' Granda, Milano, Italy. 6. Clinica San Carlo, Paderno Dugnano, Italy. 7. ULSS 15 Alta Padovana, Camposampiero, Italy. 8. Policlinico Casilino, Roma, Italy. 9. Presidio Ospedaliero Riunito, Ciriè, Italy. 10. A.O. Santa Maria Del Carmine, Rovereto, Italy. 11. Azienda Ospedaliera di Padova, Padova, Italy. 12. Azienda Ospedaliera ´Ospedale Maggiore´ di Crema, Crema, Italy. 13. Ospedale Civile di Conegliano, Conegliano Veneto, Italy. 14. GVM Care & Research Group, Cotingola, Italy. 15. Azienda Ospedaliera Careggi, Firenze, Italy. 16. Nuovo Ospedale delle Apuane, Massa, Italy.
Abstract
BACKGROUND: Catheter ablation (CA) is recommended for patients with drug refractory symptomatic atrial fibrillation (AF). "One Shot" catheters have been introduced to simplify CA and cryoballoon ablation (CBA) is spreading rapidly. Few real-world data are available on standard clinical practice, mainly from single-center experience. We aimed to evaluate clinical settings, demographics, and acute procedural outcomes in a large cohort of patients treated with CBA. METHODS: A total of 903 patients (73% male, mean age 59 ± 11) underwent pulmonary vein CBA. Correlations between the patient's inclusion time and clinical characteristics, procedure duration, acute success rate, and intraprocedural complications were evaluated. RESULTS: Seventy-seven percent of patients were affected by paroxysmal AF and 23% by persistent AF. Overall, acute success rate was 97.9% and periprocedural complications were observed in 35 (3.9%) patients, 13 (1.4%) of which were classified as major complications. With respect to the patient's inclusion time analysis, an increase in treatment of persistent AF was observed, a significant decrease in CBA times (procedure, ablation, and fluoroscopy: 136.0 ± 46.5 minutes, 28.8 ± 19.6 minutes, and 34.3 ± 15.4 minutes, respectively) was observed, with comparable acute success rate and intraprocedural complications over time. The rate of major complications was extremely low (1.4%); no death, atrioesophageal fistula, stroke, or other major periinterventional or late complications occurred. CONCLUSION: This series represents the largest experience of CBA in the treatment of AF that also describes the adoption curve of this relatively recent technology. CBA showed an excellent safety profile when performed in a large real-world clinical setting, with satisfactory acute success rate and, on average, short procedural times. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov (NCT01007474).
BACKGROUND: Catheter ablation (CA) is recommended for patients with drug refractory symptomatic atrial fibrillation (AF). "One Shot" catheters have been introduced to simplify CA and cryoballoon ablation (CBA) is spreading rapidly. Few real-world data are available on standard clinical practice, mainly from single-center experience. We aimed to evaluate clinical settings, demographics, and acute procedural outcomes in a large cohort of patients treated with CBA. METHODS: A total of 903 patients (73% male, mean age 59 ± 11) underwent pulmonary vein CBA. Correlations between the patient's inclusion time and clinical characteristics, procedure duration, acute success rate, and intraprocedural complications were evaluated. RESULTS: Seventy-seven percent of patients were affected by paroxysmal AF and 23% by persistent AF. Overall, acute success rate was 97.9% and periprocedural complications were observed in 35 (3.9%) patients, 13 (1.4%) of which were classified as major complications. With respect to the patient's inclusion time analysis, an increase in treatment of persistent AF was observed, a significant decrease in CBA times (procedure, ablation, and fluoroscopy: 136.0 ± 46.5 minutes, 28.8 ± 19.6 minutes, and 34.3 ± 15.4 minutes, respectively) was observed, with comparable acute success rate and intraprocedural complications over time. The rate of major complications was extremely low (1.4%); no death, atrioesophageal fistula, stroke, or other major periinterventional or late complications occurred. CONCLUSION: This series represents the largest experience of CBA in the treatment of AF that also describes the adoption curve of this relatively recent technology. CBA showed an excellent safety profile when performed in a large real-world clinical setting, with satisfactory acute success rate and, on average, short procedural times. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov (NCT01007474).
Authors: Giovanni Rovaris; Paolo De Filippo; Francesco Laurenzi; Gabriele Zanotto; Nicola Bottoni; Mattia Pozzi; Fabrizio Giofrè; Piergiuseppe De Girolamo; Emanuela Visentin; Elena Piazzi; Paola Ferrari Journal: J Interv Card Electrophysiol Date: 2017-09-05 Impact factor: 1.900
Authors: Luigi Sciarra; Saverio Iacopino; Giuseppe Arena; Claudio Tondo; Paolo Pieragnoli; Giulio Molon; Massimiliano Manfrin; Antonio Curnis; Antonio Dello Russo; Giovanni Rovaris; Giuseppe Stabile; Leonardo Calò; Gabriele Boscolo; Roberto Verlato Journal: Cardiol Res Pract Date: 2021-12-28 Impact factor: 1.866
Authors: Ermengol Vallès; Jesús Jiménez; Julio Martí-Almor; Jorge Toquero; José Miguel Ormaetxe; Alberto Barrera; Arcadio García-Alberola; José Manuel Rubio; Pablo Moriña; Carlos Grande; Maria Fé Arcocha; Rafael Peinado; Rocío Cózar; Julio Hernández; Luisa Pérez-Alvarez; Larraitz Gaztañaga; Angel Ferrero-De Loma-Osorio; Ricardo Ruiz-Granell; Roger Villuendas; Jesús Daniel Martínez-Alday Journal: J Clin Med Date: 2022-02-22 Impact factor: 4.241