Objective and subjective assessment of the recurrence of atrial fibrillation after cryoballoon ablation of the pulmonary veins

Abstract

Aim. To develop principles for monitoring the state of patients after cryoballoon ablation of the pulmonary veins for detection of atrial fibrillation recurrence.
 Material and methods. There was 301 patients included into the study. All of them consequentially underwent cryoballoon ablation of the pulmonary veins in the period October 2016 - November 2019.
 The inclusion criteria:
 -Symptomatic atrial fibrillation;
 -Instrumental confirmation of atrial fibrillation.
 The exclusion criteria:
 -Combination of atrial fibrillation and atrial flutter;
 -Anamnesis of any surgical procedures contra atrial fibrillation;
 -Presence of concomitant cardiac and "arrhythmogenic" pathology.
 Results. In the period 01 - 30 May 2020, 100% (N = 301) of the patients were examined by the method of targeted survey. The median duration of the postoperative period was 21 (3; 43) months.
 There was 136 (45%) patients noted a return of complaints associated with atrial fibrillation recurrence in the postoperative period.
 There was a clear tendency towards a decrease in the total number of patients with complaints of clinical recurrence of the disease, depending on the time elapsed since the surgical procedure. The longer the period from the moment of surgery, the fewer patients with recurrence.
 Of 136 patients with recurrent complaints associated with atrial fibrillation, 97 (71%) were able to conduct daily monitoring of the electrocardiogram. Of these, the instrumental recurrence of atrial fibrillation was confirmed in 59 patients, which amounted to 20% of all patients included in the study (N = 301).
 Conclusion. To establish the true number of atrial fibrillation recurrence after cryoballoon ablation of the pulmonary veins, there are targeted survey of patients should be used up to 12 months after surgery. The patients, who at the same time have complaints that indicate atrial fibrillation recurrence, even if these complaints do not correspond to the preoperative ones, should invited for instrumental diagnostics of arrhythmia.