Leonard Bergau1, Mustapha El Hamriti1, Kerstin Rubarth2,3, Lilas Dagher4, Stephan Molatta1, Martin Braun1, Moneeb Khalaph1, Guram Imnadze1, Georg Nölker5, Claus P Nowak2,3, Henrik Fox6, Philipp Sommer1, Christian Sohns1. 1. Clinic for Electrophysiology, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum, Bad Oeynhausen, Germany. 2. Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Berlin, Germany. 3. Berlin Institute of Health (BIH), Berlin, Germany. 4. Department of Cardiology, Tulane University School of Medicine, New Orleans, Louisiana, USA. 5. Clinic for Cardiology, Katharinen-Hospital Unna, Unna, Germany. 6. Clinic for Thoracic and Cardiovascular Surgery and Heart Failure Department, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Abstract
INTRODUCTION: Cryoballoon (CB)-guided ablation of atrial fibrillation (AF) is established in symptomatic AF patients. This study sought to determine the safety and efficacy of CB pulmonary vein isolation (PVI) in young adults. METHODS AND RESULTS: A total of 93 consecutive patients aged <45 years referred to our center for AF ablation were included in this observational study. All patients received CB-guided PVI according to a standardized institutional protocol. Follow-up was performed in our outpatient clinic using 72-h Holter monitoring and periodic telephone interview. Recurrence was defined as any AF/atrial tachycardia (AT) episode >30 s following a 3-month blanking period. A propensity matched control group consisting of patients older than 45 years were used for further evaluation. Mean age was 35 ± 7 years, 22% suffered from persistent AF, 85% were male. Mean follow-up was 2.6 ± 2 years. At the end of the observational period, 83% of patients were free of any AF/AT episodes. There was an excellent overall 12-month success rate of 92%. In comparison to a matched group the overall recurrence rate was noticeably lower in the young group (15% vs. 27%). Increasing age was associated with a hazard ratio of 1.16 for recurrence. In a multivariate analysis model, left atrial diameter remained as significant predictor of AF/AT recurrence. The complication rate was low, no permanent phrenic nerve palsy was observed. CONCLUSION: CB-guided PVI in young adults is safe and effective with favorable long-term results. It may be considered as first-line therapy in this relatively healthy population.
INTRODUCTION: Cryoballoon (CB)-guided ablation of atrial fibrillation (AF) is established in symptomatic AFpatients. This study sought to determine the safety and efficacy of CB pulmonary vein isolation (PVI) in young adults. METHODS AND RESULTS: A total of 93 consecutive patients aged <45 years referred to our center for AF ablation were included in this observational study. All patients received CB-guided PVI according to a standardized institutional protocol. Follow-up was performed in our outpatient clinic using 72-h Holter monitoring and periodic telephone interview. Recurrence was defined as any AF/atrial tachycardia (AT) episode >30 s following a 3-month blanking period. A propensity matched control group consisting of patients older than 45 years were used for further evaluation. Mean age was 35 ± 7 years, 22% suffered from persistent AF, 85% were male. Mean follow-up was 2.6 ± 2 years. At the end of the observational period, 83% of patients were free of any AF/AT episodes. There was an excellent overall 12-month success rate of 92%. In comparison to a matched group the overall recurrence rate was noticeably lower in the young group (15% vs. 27%). Increasing age was associated with a hazard ratio of 1.16 for recurrence. In a multivariate analysis model, left atrial diameter remained as significant predictor of AF/AT recurrence. The complication rate was low, no permanent phrenic nerve palsy was observed. CONCLUSION: CB-guided PVI in young adults is safe and effective with favorable long-term results. It may be considered as first-line therapy in this relatively healthy population.
Authors: Denise Guckel; Philipp Lucas; Khuraman Isgandarova; Mustapha El Hamriti; Leonard Bergau; Thomas Fink; Vanessa Sciacca; Martin Braun; Moneeb Khalaph; Guram Imnadze; Georg Nölker; Philipp Sommer; Christian Sohns Journal: J Interv Card Electrophysiol Date: 2022-06-28 Impact factor: 1.759
Authors: Denise Guckel; Philipp Lucas; Khuraman Isgandarova; Mustapha El Hamriti; Leonard Bergau; Thomas Fink; Vanessa Sciacca; Guram Imnadze; Martin Braun; Moneeb Khalaph; Georg Nölker; Philipp Sommer; Christian Sohns Journal: J Cardiovasc Dev Dis Date: 2022-01-08