Regular atrial tachycardias following pulmonary vein isolation for paroxysmal atrial fibrillation: a retrospective comparison between the cryoballoon and conventional focal tip radiofrequency techniques

Juliá, Justo; Chierchia, Gian Battista; Asmundis, Carlo de; Mugnai, Giacomo; Sieira, Juan; Ciconte, Giuseppe; Giovanni, Giacomo Di; Conte, Giulio; Baltogiannis, Giannis; Saitoh, Yukio; Wauters, Kristel; Irfan, Ghazala; Brugada, Pedro

doi:10.1007/s10840-014-9961-4

Cited by 32 publications

(30 citation statements)

References 27 publications

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“…No significant differences were observed both in complication rates and in procedural/fluoroscopy times between different operators. In the present study rapid atrial tachycardias, including common right atrial flutter, occurred significantly more frequently in the RF group (61 patients, 9.5%) vs CB group (21 patients, 3.5%; p = 0.0001), as previously reported [23]. When excluding common right atrial flutter, the incidence of rapid atrial tachycardia remained still significantly higher in the RF group (7.3% vs 2.5%; p = 0.0001).…”

Section: Complications In Rf and Cb Groupssupporting

confidence: 90%

Complications in the setting of percutaneous atrial fibrillation ablation using radiofrequency and cryoballoon techniques: A single-center study in a large cohort of patients

Mugnai¹,

Irfan²,

Asmundis³

et al. 2015

International Journal of Cardiology

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Section: Complications In Rf and Cb Groupssupporting

confidence: 90%

Complications in the setting of percutaneous atrial fibrillation ablation using radiofrequency and cryoballoon techniques: A single-center study in a large cohort of patients

Mugnai¹,

Irfan²,

Asmundis³

et al. 2015

International Journal of Cardiology

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“…Akerström et al. and Juliá reported higher prevalences of LAT after radiofrequency PVI than after cryoballoon ablation, with rates of 4.8% vs. 2.8% (P = 0.225) and 9.1% vs. 2.0% (P = 0.011), respectively. RF was even a predictive factor of LAT with borderline significance according to Juliá.…”

Section: Discussionmentioning

confidence: 95%

“…reported only two cases (1.1% of patients), Akerström et al . reported six cases (2.8% of patients), and Juliá et al . reported two cases (2%).…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, three published studies have reported data about pcryo‐LAT after cryoballoon ablation. However, the present study is the first evaluation of pcryo‐LAT occurring exclusively after second generation cryoballoon and including persistent atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

“…Only Akerström described a macroreentrant mechanism for pcryo‐LAT (three of the six cases of pcryo‐LAT), while Mikhaylov and Juliá only reported cases of focal tachycardia.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and predictive factors of left atrial tachycardia occurring after second‐generation cryoballoon ablation of atrial fibrillation

Hermida

Kubala

Traullé

et al. 2017

Cardiovasc electrophysiol

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Introduction: Assess the prevalence and predictors of left atrial tachycardia (LAT) after cryoballoon ablation of pulmonary veins. Methods and results:Patients who underwent catheter ablation of pulmonary veins with a second-generation cryoballoon for symptomatic paroxysmal (151 of 270, 56%) or persistent (119 of 270, 44%) atrial fibrillation were entered in a single-center prospective registry. Patients who experienced postcryoballoon LAT (pcryo-LAT) were selected on the basis of 12-lead ECG characteristics. Left atrial origin was confirmed during conventional EP study and electroanatomical activation mapping, and patients were treated by RF catheter ablation.Pcryo-LAT was observed in 15 (5.6%) of 270 patients and was attributed to a reentrant mechanism in 11 patients (73%). The other four cases of pcryo-LAT were due to focal atrial tachycardia associated with reconnection of one pulmonary vein. In comparison with patients who remained in sinus rhythm, LA area (HR = 1.09; CI 1.01, 1.2; P = 0.02), LVEF (HR = 0.94; CI 0.90, 0.97; P < 0.001), and LVEF <50% (HR = 8.5; CI 3.1, 23.6; P < 0.001) were predictors of pcryo-LAT. After multivariate Cox analysis, only left ventricular ejection fraction < 50% remained predictive of pcryo-LAT, (HR = 7.8, CI 2.3 26.7, P = 0.002). With a mean survival of 23 months, 73% of patients who experienced pcryo-LAT were in sinus rhythm versus 78% of patients without pcryo-LAT (log rank P = 0.85). Conclusion:The prevalence of pcryo-LAT in patients with atrial fibrillation is low. Left ventricular ejection fraction < 50% is associated with an increased risk of pcryo-LAT. When treated by RF catheter ablation, the presence of pcryo-LAT is not a predictive factor of subsequent recurrence of atrial fibrillation during follow-up.

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Cryoballoon ablation of the left atrial posterior wall reduces recurrence of persistent atrial fibrillation in patients with non‐paroxysmal atrial fibrillation

Shigeta

Yamauchi

Sagawa

et al. 2021

Journal of Arrhythmia

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Background This study aimed to clarify the clinical outcomes of cryoballoon ablation of the left atrial (LA) posterior wall (LAPW), including the LA roof, in patients with non‐paroxysmal atrial fibrillation (AF). Methods We analyzed the outcomes of 284 patients with non‐paroxysmal AF, of whom 210 underwent the cryoballoon ablation of the LAPW, including the LA roof, in addition to pulmonary vein isolation with a cryoballoon. Results Complete conduction block at the LA roof was obtained in 95.7% (201/210) of patients, and LAPW was isolated in 83.3% (130/156) of patients. Over 372 (range, 208–477) days of follow‐up, atrial arrhythmia recurrence was observed in 84 (29.6%) patients, and atrial tachycardia (AT) recurrence accounted for 27.4% of cases. The prevalence of LA roof cryoballoon ablation was significantly higher in patients without recurrence than in those with recurrence (78.6% vs. 63.1%, respectively; p = .01), especially those with persistent AF recurrence (77.0% vs. 55.0%, p = .01). No significant difference was found in the prevalence of AT recurrence between patients who had undergone additional LAPW ablation and those who had not. Durable LA roof lesions were confirmed in 29 (72.5%) of 40 patients who underwent redo ablation. Conclusions Cryoballoon ablation of the LAPW leads to a sufficient acute success rate of complete conduction block and durable lesions of the LA roof without increasing AT recurrence risk. The prevalence of persistent AF recurrence decreases after additional cryoballoon ablation of the LAPW in patients with non‐paroxysmal AF.

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Regular atrial tachycardias following pulmonary vein isolation for paroxysmal atrial fibrillation: a retrospective comparison between the cryoballoon and conventional focal tip radiofrequency techniques

Abstract: Patients with PAF undergoing a first PV isolation procedure by means of CB ablation present a significantly lower incidence of ATs than those in which PV isolation is achieved by means of circumferential point by point RF ablation.

Cited by 32 publications

References 27 publications

Complications in the setting of percutaneous atrial fibrillation ablation using radiofrequency and cryoballoon techniques: A single-center study in a large cohort of patients

Complications in the setting of percutaneous atrial fibrillation ablation using radiofrequency and cryoballoon techniques: A single-center study in a large cohort of patients

Prevalence and predictive factors of left atrial tachycardia occurring after second‐generation cryoballoon ablation of atrial fibrillation

Cryoballoon ablation of the left atrial posterior wall reduces recurrence of persistent atrial fibrillation in patients with non‐paroxysmal atrial fibrillation

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