BACKGROUND: Parameters predicting the second-generation cryoballoon pulmonary vein isolation (CB-PVI) durability of each individual PV have not been investigated. OBJECTIVE: We explored the PVI durability predictors after left superior (LS), left inferior (LI), right superior (RS), and right inferior (RI) PV CB-PVI. METHODS: Data from 101 consecutive patients who underwent repeat procedures 7.0 [4.5-10.0] months after index cryoballoon procedures with single short freeze strategies were analyzed. RESULTS: Among 369 PVs successfully isolated by cryoballoons with mean freezing times of 207 s, 82/94 (87.2%) LSPVs, 78/93 (83.9%) LIPVs, 80/98 (81.6%) RSPVs, and 63/84 (75.0%) RIPVs were durable. In the remaining 25 PVs requiring touch-up ablation, 20 (83.3%) PVs had reconnections. In analyzing all PVs together, lower nadir balloon temperature, faster freezing speed (FS), slower thawing speed (TS), and shorter time-to-isolation were significantly associated with higher PVI durability, however, all parameters significantly differed among the 4 individual PVs (p < 0.0001). In individual analyses, for the LSPV, faster FS to -40 °C predicted higher PVI durability, but younger patients more likely had reconnections. For the LIPV, faster FS to -30 °C predicted higher PVI durability. For the RSPV, a lower nadir temperature, faster FS (to -30 and -40 °C), slower TS (to 0 and 15 °C), shorter time-to-isolation, and smaller PV diameter predicted higher PVI durability. For the RIPV, a slower TS (to 0 and 15 °C) predicted higher PVI durability. CONCLUSIONS: The durability of the CB-PVI was high even with a single short freeze strategy. The parameters predicting the PVI durability differed among the 4 PVs, suggesting that best freeze criterion should be considered separately for each of the 4 PVs.
BACKGROUND: Parameters predicting the second-generation cryoballoon pulmonary vein isolation (CB-PVI) durability of each individual PV have not been investigated. OBJECTIVE: We explored the PVI durability predictors after left superior (LS), left inferior (LI), right superior (RS), and right inferior (RI) PV CB-PVI. METHODS: Data from 101 consecutive patients who underwent repeat procedures 7.0 [4.5-10.0] months after index cryoballoon procedures with single short freeze strategies were analyzed. RESULTS: Among 369 PVs successfully isolated by cryoballoons with mean freezing times of 207 s, 82/94 (87.2%) LSPVs, 78/93 (83.9%) LIPVs, 80/98 (81.6%) RSPVs, and 63/84 (75.0%) RIPVs were durable. In the remaining 25 PVs requiring touch-up ablation, 20 (83.3%) PVs had reconnections. In analyzing all PVs together, lower nadir balloon temperature, faster freezing speed (FS), slower thawing speed (TS), and shorter time-to-isolation were significantly associated with higher PVI durability, however, all parameters significantly differed among the 4 individual PVs (p < 0.0001). In individual analyses, for the LSPV, faster FS to -40 °C predicted higher PVI durability, but younger patients more likely had reconnections. For the LIPV, faster FS to -30 °C predicted higher PVI durability. For the RSPV, a lower nadir temperature, faster FS (to -30 and -40 °C), slower TS (to 0 and 15 °C), shorter time-to-isolation, and smaller PV diameter predicted higher PVI durability. For the RIPV, a slower TS (to 0 and 15 °C) predicted higher PVI durability. CONCLUSIONS: The durability of the CB-PVI was high even with a single short freeze strategy. The parameters predicting the PVI durability differed among the 4 PVs, suggesting that best freeze criterion should be considered separately for each of the 4 PVs.
Authors: M N Klaver; L I S Wintgens; M C E F Wijffels; V F van Dijk; A Alipour; S M Chaldoupi; R Derksen; J Peper; J C Balt; L V A Boersma Journal: J Interv Card Electrophysiol Date: 2022-05-23 Impact factor: 1.900
Authors: Piotr Kulakowski; Agnieszka Sikorska; Roman Piotrowski; Tomasz Kryński; Jakub Baran Journal: J Interv Card Electrophysiol Date: 2021-01-09 Impact factor: 1.900