One-year follow-up after second-generation cryoballoon ablation for atrial fibrillation in a large cohort of patients: a single-centre experience

Irfan, Ghazala; Asmundis, Carlo de; Mugnai, Giacomo; Poelaert, Jan; Verborgh, Christian; Umbrain, Vincent; Beckers, Stefan; Hacioğlu, Ebru; Hünük, Burak; Velagić, Vedran; Ströker, Erwin; Brugada, Pedro; Chierchia, Gian‐Battista

doi:10.1093/europace/euv365

Cited by 52 publications

(42 citation statements)

References 24 publications

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“…The AT recurrence‐free survival after a single ablation procedure with the CB2 was 87% in this study, which was comparable to the other studies . However, in the Group A patients, the AT recurrence‐free rate significantly declined compared to that in Group B.…”

Section: Discussionsupporting

confidence: 84%

“…The AT recurrence-free survival after a single ablation procedure with the CB2 was 87% in this study, which was comparable to the other studies. 18,19 However, in the Group A patients, the AT recurrence-free rate significantly declined compared to that in Group B. We speculated that an arrhythmogenic PV antrum area was apt to be spared from the PVI in the Group A patients using the CB2.…”

Section: F I G U R Ementioning

confidence: 90%

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Clinical assessment of cryoballoon ablation in cases with atrial fibrillation and a left common pulmonary vein

Shigeta

Okishige

Yamauchi

et al. 2017

Cardiovasc electrophysiol

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Section: Discussionsupporting

confidence: 84%

Section: F I G U R Ementioning

confidence: 90%

Clinical assessment of cryoballoon ablation in cases with atrial fibrillation and a left common pulmonary vein

Shigeta

Okishige

Yamauchi

et al. 2017

Cardiovasc electrophysiol

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“…All procedures were performed as previously reported . Briefly, after gaining echo‐guided access to the left atrial (LA), cryoenergy applications were performed at each vein with the 28 mm CB2 (Arctic Front Advance; Medtronic, Minneapolis, MN).…”

Section: Methodsmentioning

confidence: 99%

Anatomic predictors of late right inferior pulmonary vein reconnection in the setting of second‐generation cryoballoon ablation

Terasawa

Chierchia

Takarada

et al. 2019

Cardiovasc electrophysiol

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Introduction The right inferior pulmonary vein (RIPV) accounts as the most frequently reconnected vein after pulmonary vein isolation using second‐generation cryoballoon ablation (CB‐A). Our objective was to assess anatomic predictors of late RIPV reconnection based on preprocedural computed tomography scan. Methods Patients with a repeat procedure for atrial tachyarrhythmia recurrence after index CB‐A procedure were included. A total of 129 RIPVs were evaluated for ostial diameters, ostial area, and branching pattern. Interior angle between RIPV and horizontal line in the frontal/transversal plane was used to measure the RIPV orientation: RIPV frontal/transversal angle, respectively. In addition, interior angle between RIPV and the line perpendicular on the septal intersection line at the level of the fossa ovalis, estimated as trans‐septal (TS) puncture site, was measured in the frontal/transversal view: RIPV‐TS frontal/transversal angle, respectively. Results Late vein reconnection was present in 36/129 RIPVs (28%). Warmer balloon nadir temperature (P = .01), more inferior (P < .001) and posterior (P < .01) RIPV orientation (ie, more positive RIPV frontal and RIPV transversal angle, respectively), and sharper RIPV‐TS frontal angle (P < .001) were associated with late RIPV reconnection on univariate analysis. Independent variables after multivariate analysis were nadir temperature (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.03‐1.23; P = .013) and RIPV frontal angle (OR, 1.13, CI, 1.07‐1.19; P < .001). Conclusion Frontal RIPV orientation could significantly predict late RIPV electrical reconnection after CB‐A. Therefore, preprocedural anatomic assessment of the RIPV might be useful to plan the correct ablation strategy.

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“…After excluding non-compliant documents, only 16 articles were included in this study. In the remaining 16 articles [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], ERAF, LAD, AF duration, and persistent AF were mentioned 14, eight, six, and four times, respectively. There were three retrospective studies, 12 prospective studies, and one case-control study in the final 16 articles.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

“…After excluding the four studies [7,10,15,18] that had the fewest enrolled patients, the analysis did not find a significant influence on heterogeneity across studies or overall results (HR 4.20; 95% CI 2.59-6.79; p < 0.00001), (p < 0.00001, I 2 = 88%). After excluding the four studies [4,5,8,10] that included studies without prospective studies, the analysis was only slightly changed in terms of the overall risk (HR: 4.69; 95% CI 2.91-7.58; p < 0.00001), and no evidence of heterogeneity was observed among the remaining studies Figure 7 shows a funnel plot of the HR of the ERAF in the all patients. Studies were not distributed within the 95% CI area.…”

Section: Procedural Outcomesmentioning

confidence: 99%

Predictors of late atrial fibrillation recurrence after cryoballoon-based pulmonary vein isolation: a meta-analysis

et al. 2017

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A b s t r a c t Background:The recurrence rate of atrial fibrillation (AF) after cryoballoon ablation in drug refractory AF patients is high. Late-recurrence of AF has various predictors. Aim:The aim of the study was to explore the related risk factors that can effectively predict late AF recurrence after cryoballoon-based pulmonary vein isolation. Methods:The PubMed and Web of Science databases were searched from 1 January 2013 to 1 August 2016, and studies were chosen that met the pre-stated inclusion criteria. The reference lists of the retrieved articles were also reviewed. Two authors independently extracted information on the designs of the studies. The strength of the relationship between different risk factors and late recurrence was assessed by the adjusted hazard ratio.Results: A total of 16 papers met the inclusion criteria and were included in the meta-analysis. The hazard ratio of late atrial arrhythmia recurrence in patients with early recurrence was 4.19 compared with the reference group (95% CI 2.73-6.44, p < 0.00001); that of increased left atrial diameter was 1.25 (95% CI 1.12-1.3, p < 0.0001); that of a long duration of AF before ablation was 1.10 (95% CI 1.04-1.17, p < 0.0009); and that of persistent AF was 2.44 (95% CI 1.30-4.58, p < 0.006). However, there exists significant heterogeneity for each indicator, and a slight publication bias was observed. Conclusions:Our study suggests that early recurrence in the blanking period, increased left atrial size, a long duration of AF before ablation and persistent AF are independent predictors of late recurrence after cryoballoon ablation.

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One-year follow-up after second-generation cryoballoon ablation for atrial fibrillation in a large cohort of patients: a single-centre experience

Cited by 52 publications

References 24 publications

Clinical assessment of cryoballoon ablation in cases with atrial fibrillation and a left common pulmonary vein

Clinical assessment of cryoballoon ablation in cases with atrial fibrillation and a left common pulmonary vein

Anatomic predictors of late right inferior pulmonary vein reconnection in the setting of second‐generation cryoballoon ablation

Predictors of late atrial fibrillation recurrence after cryoballoon-based pulmonary vein isolation: a meta-analysis

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