A novel risk model for very late return of atrial fibrillation beyond 1 year after cryoballoon ablation: the SCALE-CryoAF score

Peigh, Graham; Kaplan, Rachel; Bavishi, Aakash; Diaz, Celso L.; Baman, Jayson R.; Matiasz, Richard; Trivedi, Amar; Sattayaprasert, Prasongchai; Wasserlauf, Jeremiah; Shen, Mark J.; Potpara, Tatjana; Chicos, Alexandru B.; Arora, Rishi; Kim, Susan; Lin, Albert; Verma, Nishant; Knight, Bradley P.; Passman, Rod

doi:10.1007/s10840-019-00588-x

Cited by 15 publications

(35 citation statements)

References 28 publications

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“…Provocative maneuvers after CBA to induce atrial arrhythmias were performed at the discretion of the operator. Cardioversion to sinus rhythm was performed if a patient remained in AF after CBA 22,23 …”

Section: Methodsmentioning

confidence: 99%

Repeat pulmonary vein isolation with or without FIRM‐guided ablation for recurrent atrial fibrillation with pulmonary vein reconnection

Peigh

Wasserlauf

Kaplan

et al. 2020

Cardiovasc electrophysiol

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Introduction: Focal impulse and rotor modulation (FIRM) ablation can be used to target nonpulmonary vein (PV) sources of atrial fibrillation (AF). No published studies have compared freedom from atrial fibrillation (FFAF) after pulmonary vein reisolation (PVRI) plus FIRM to PVRI alone in patients with reconnected PVs undergoing repeat ablation. Methods: A 3:1 matched retrospective cohort study was performed on 21 patients with recurrent AF and PV reconnection who underwent PVRI plus FIRM-guided ablation and 63 patients with recurrent AF treated with PVRI alone at a single institution. All patients in the PVRI-alone cohort had cryoballoon PVRI at the time of repeat ablation without additional lesion sets for AF. Cases were matched based on the type of AF (paroxysmal vs nonparoxysmal), left atrial diameter (±4 mm), left ventricular ejection fraction (±10%), duration of AF (±18 months), and age (±5 years). The primary endpoint was FFAF after a 3-month blanking period. Results: Out of 53 total FIRM cases performed at Northwestern Memorial Hospital between 2015 and 2017, 21 patients had PVRI plus FIRM for recurrent AF with PV reconnection. These patients had an average of 3.3 ± 2.1 rotors (60% left atrial) ablated. Over a median follow-up time of 24.7 months (interquartile range, 13-36 months), patients in the PVRI-alone cohort demonstrated a higher rate of FFAF (n = 35; 55.6%) than patients in the PVRI plus FIRM-guided ablation cohort (n = 7; 33.3%) (logrank P = .049). Conclusion: In patients undergoing repeat ablation for AF with PV reconnection, PVRI plus FIRM did not increase FFAF compared to PVRI alone. K E Y W O R D S atrial fibrillation ablation, cryoballoon ablation, focal impulse and rotor modulation How to cite this article: Peigh G, Wasserlauf J, Kaplan RM, et al. Repeat pulmonary vein isolation with or without FIRM-guided ablation for recurrent atrial fibrillation with pulmonary vein reconnection.

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Section: Methodsmentioning

confidence: 99%

Repeat pulmonary vein isolation with or without FIRM‐guided ablation for recurrent atrial fibrillation with pulmonary vein reconnection

Peigh

Wasserlauf

Kaplan

et al. 2020

Cardiovasc electrophysiol

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“…Likewise, the combination of ranolazine and low-dose dronedarone reduced the AF burden (mean duration of AF episodes) by 59% as compared to placebo in the HARMONY clinical trial ( Reiffel et al, 2015 ). The synergistic activity between ranolazine and dronedarone can potentially reduce the dose needed and reduce the adverse effects associated with dronedarone monotherapy.…”

Section: Emerging Antiarrhythmic Drugs For Rhythm Controlmentioning

confidence: 99%

“…In the United States, extended longevity from medical advances has led to the projection of up to 15 million patients diagnosed with AF by 2050 (Miyasaka et al, 2006;Colilla et al, 2013). Modifiable risk factors for developing AF within 10 years (Schnabel et al, 2009) include hypertension, diabetes mellitus (Patel et al, 2014), coronary artery disease (Peigh et al, 2020), heart failure, obesity (Thacker et al, 2013), and obstructive sleep apnea (Youssef et al, 2018). Non-modifiable AF risk factors include valvular heart disease (Banerjee et al, 2019), hypertrophic cardiomyopathy (Olivotto et al, 2001), and congenital heart disease (Hu and Lin, 2019).…”

Section: Introductionmentioning

confidence: 99%

Revisiting Antiarrhythmic Drug Therapy for Atrial Fibrillation: Reviewing Lessons Learned and Redefining Therapeutic Paradigms

2020

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“…To facilitate patient counselling and selection for CB ablation several risk scales that assess the risk of AF recurrence after CB ablation were proposed [ 6 ]. The major risk factors connected with AF recurrence include persistent AF type, obesity, enlargement of the left atrium and reduced ejection fraction of the left ventricle.…”

Section: Introductionmentioning

confidence: 99%

Cryoballoon pulmonary vein isolation as a standard approach for interventional treatment of atrial fibrillation. A review and a practical guide to an effective and safe procedure

Kiełbasa

Jastrzębski

2020

pwki

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Since the cryoballoon was introduced into clinical practice, approximately half a million patients have undergone a pulmonary vein isolation (PVI) using this tool throughout the world. This single-shot technique makes the pulmonary vein isolation procedure easier and has the potential to expand access to the interventional treatment of atrial fibrillation (AF), eventually leading to a reduction of the AF-related disease burden. Several studies and metanalyses have assessed the acute and long-term efficacy of cryoballoon-based PVI. The reported success rate of PV isolation during the procedure is about 98%. Despite this, the long-term effectiveness of the procedure (AF free survival) assessed at 1 year after the ablation is in the range of 70–82%. The AF-free survival rate significantly depends on the clinical characteristics of the studied group and the presence of risk factors, especially the type of AF (paroxysmal vs. persistent), LA size and the presence of heart failure. For a safe and effective procedure the electrophysiologist should be aware of all minute details of the procedure including several tricks developed by the most experienced operators and the pre-procedural and post-procedural management recommendations. Detailed knowledge of complications of cryoballoon (CB)-based ablation is mandatory. This review concentrates on the practical aspects and recommendations for a cryoballoon ablation procedure. The review is based on the authors’ experience, including 800 procedures performed over 11 years with a low complication rate, and is presented within the context of the literature.

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A novel risk model for very late return of atrial fibrillation beyond 1 year after cryoballoon ablation: the SCALE-CryoAF score

Cited by 15 publications

References 28 publications

Repeat pulmonary vein isolation with or without FIRM‐guided ablation for recurrent atrial fibrillation with pulmonary vein reconnection

Repeat pulmonary vein isolation with or without FIRM‐guided ablation for recurrent atrial fibrillation with pulmonary vein reconnection

Revisiting Antiarrhythmic Drug Therapy for Atrial Fibrillation: Reviewing Lessons Learned and Redefining Therapeutic Paradigms

Cryoballoon pulmonary vein isolation as a standard approach for interventional treatment of atrial fibrillation. A review and a practical guide to an effective and safe procedure

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