Claudio Tondo1, Saverio Iacopino2, Paolo Pieragnoli3, Giulio Molon4, Roberto Verlato5, Antonio Curnis6, Maurizio Landolina7, Giuseppe Allocca8, Giuseppe Arena9, Gaetano Fassini10, Luigi Sciarra11, Mario Luzi12, Massimiliano Manfrin13, Luigi Padeletti14. 1. Heart Rhythm Center at Monzino Cardiac Center, IRCCS Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. Electronic address: claudio.tondo@ccfm.it. 2. GVM Care & Research Group, Cotignola, Italy. 3. Careggi Hospital, University of Florence, Firenze, Italy. 4. Sacro Cuore Don Calabria Hospital - Negrar, Verona, Italy. 5. ULSS 15 Alta Padovana, Camposampiero, Italy. 6. Azienda Ospedaliera Spedali Civili, Brescia, Italy. 7. Azienda Ospedaliera 'Ospedale Maggiore' di Crema, Crema, Italy. 8. Ospedale Civile di Conegliano Veneto, Vento, Italy. 9. Nuovo Ospedale delle Apuane, Massa, Italy. 10. Heart Rhythm Center at Monzino Cardiac Center, IRCCS Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 11. Policlinico Casilino, Rome, Italy. 12. AO Universitaria Osp. Riuniti, Clinica di Cardiologia e Aritmologia, Torrette, Ancona, Italy. 13. Ospedale Centrale di Bolzano, Divisione di Cardiologia, Bolzano, Italy. 14. University of Florence, Firenze, Italy; IRCCS Multimedica, Milano, Italy.
Abstract
BACKGROUND: Pulmonary vein isolation (PVI) is a cornerstone ablation strategy in the management of patients with atrial fibrillation (AF). Consensus guidelines and statements recommend PVI during the index catheter ablation procedure in patients with paroxysmal and persistent AF. OBJECTIVE: The objective of this analysis was to evaluate patients with persistent and long-standing persistent AF who were treated with the cryoballoon ablation catheter by PVI technique. METHODS: Consecutive patients with drug-refractory symptomatic persistent and long-standing persistent AF who underwent cryoballoon catheter ablation by a PVI-only procedure were prospectively included in this single-arm multicenter evaluation. Data on procedural characteristics, safety, and long-term freedom from AF recurrence were analyzed. RESULTS: Four hundred eighty-six subjects (mean age 60.8 ± 9.3 years; 389 (80%) men; 434 (89.3%) with persistent AF; 52 (10.7%) with long-standing persistent AF; left atrial diameter 44.6 ± 6.2 mm) underwent cryoballoon ablation in 35 Italian centers. The mean procedure time (skin-to-skin) was 109.9 ± 52.9 minutes, and the mean fluoroscopy time was 29.6 ± 14.5 minutes. Periprocedural complications were observed in 21 subjects (4.3%), and the acute PVI success rate was 97.6% across all patients. Using a 90-day blanking period, the single procedure Kaplan-Meier estimates of AF event-free survival were 63.9% at 12 months and 51.5% at 18 months. CONCLUSION: In this multicenter evaluation of cryoballoon ablation, the PVI procedure was safe, effective, and efficient with regard to the treatment of patients with persistent and long-standing persistent AF. The reasonable mid-term success rates agree with current clinical studies that establish PVI as a cornerstone index ablation strategy.
BACKGROUND: Pulmonary vein isolation (PVI) is a cornerstone ablation strategy in the management of patients with atrial fibrillation (AF). Consensus guidelines and statements recommend PVI during the index catheter ablation procedure in patients with paroxysmal and persistent AF. OBJECTIVE: The objective of this analysis was to evaluate patients with persistent and long-standing persistent AF who were treated with the cryoballoon ablation catheter by PVI technique. METHODS: Consecutive patients with drug-refractory symptomatic persistent and long-standing persistent AF who underwent cryoballoon catheter ablation by a PVI-only procedure were prospectively included in this single-arm multicenter evaluation. Data on procedural characteristics, safety, and long-term freedom from AF recurrence were analyzed. RESULTS: Four hundred eighty-six subjects (mean age 60.8 ± 9.3 years; 389 (80%) men; 434 (89.3%) with persistent AF; 52 (10.7%) with long-standing persistent AF; left atrial diameter 44.6 ± 6.2 mm) underwent cryoballoon ablation in 35 Italian centers. The mean procedure time (skin-to-skin) was 109.9 ± 52.9 minutes, and the mean fluoroscopy time was 29.6 ± 14.5 minutes. Periprocedural complications were observed in 21 subjects (4.3%), and the acute PVI success rate was 97.6% across all patients. Using a 90-day blanking period, the single procedure Kaplan-Meier estimates of AF event-free survival were 63.9% at 12 months and 51.5% at 18 months. CONCLUSION: In this multicenter evaluation of cryoballoon ablation, the PVI procedure was safe, effective, and efficient with regard to the treatment of patients with persistent and long-standing persistent AF. The reasonable mid-term success rates agree with current clinical studies that establish PVI as a cornerstone index ablation strategy.
Authors: Federico Cecchini; Giacomo Mugnai; Saverio Iacopino; Juan Pablo Abugattas; Bert Adriaenssens; Maysam Al-Housari; Alexandre Almorad; Gezim Bala; Antonio Bisignani; Carlo de Asmundis; Yves De Greef; Riccardo Maj; Thiago G Osòrio; Luigi Pannone; Bruno Schwagten; Juan Sieira; Antonio Sorgente; Erwin Stroker; Michael Wolf; Gian-Battista Chierchia Journal: J Interv Card Electrophysiol Date: 2022-07-22 Impact factor: 1.759
Authors: Alfred J Albano; Jared Bush; Jessica L Parker; Kristin Corner; Hae W Lim; Michael P Brunner; Musa I Dahu; Sanjay Dandamudi; Darryl Elmouchi; Andre Gauri; Alan Woelfel; Nagib T Chalfoun Journal: J Atr Fibrillation Date: 2019-08-31
Authors: Gaëlle Vermeersch; Juan-Pablo Abugattas; Varnavas Varnavas; Jeroen De Cocker; Bruno Schwagten; Juan Sieira; Carlo de Asmundis; Gian-Battista Chierchia; Yves De Greef Journal: J Arrhythm Date: 2021-03-26