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Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation: Procedural Differences and Results from the Spanish Registry (RECABA)
  • +17
  • Ermengol Valles,
  • Jesus Jimenez,
  • Julio Martí-Almor,
  • Jorge Toquero,
  • Jose Ormaetxe,
  • Alberto Barrera-Cordero,
  • Arcadi García-Alberola,
  • Jose Manuel Rubio,
  • PABLO MORIÑA-VÁZQUEZ,
  • Carlos Grande,
  • Maria Fe Arcocha,
  • Rafael Peinado,
  • Rocio Cozar,
  • Julio Salvador Hernandez Afonso,
  • Luisa Perez Alvarez,
  • Larraitz Gaztañaga,
  • Angel Ferrero,
  • Ricardo Ruiz Granell,
  • Roger Villuendas,
  • jesus martinez-alday
Ermengol Valles
Hospital del Mar Institute for Medical Research
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Jesus Jimenez
Hospital del Mar Institute for Medical Research
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Julio Martí-Almor
Hospital del Mar Institute for Medical Research
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Jorge Toquero
Puerta de Hierro University Hospital of Majadahonda
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Jose Ormaetxe
Hospital de Basurto
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Alberto Barrera-Cordero
Hospital Universitario Virgen de la Victoria
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Arcadi García-Alberola
Virgen de la Arrixaca University Hospital
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Jose Manuel Rubio
Fundacion Jimenez Diaz-UTE
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PABLO MORIÑA-VÁZQUEZ
Hospital Juan Ramon Jimenez
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Carlos Grande
Son Espases University Hospital
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Maria Fe Arcocha
Hospital de Araba
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Rafael Peinado
La Paz University Hospital
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Rocio Cozar
Virgen Macarena University Hospital
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Julio Salvador Hernandez Afonso
Hospital Universitario Nuestra Senora de la Candelaria
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Luisa Perez Alvarez
Complexo Hospitalario Universitario A Coruna
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Larraitz Gaztañaga
Basurto University Hospital
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Angel Ferrero
Quiron Valencia Clinic
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Ricardo Ruiz Granell
Quiron Valencia Clinic
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Roger Villuendas
Germans Trias i Pujol University Hospital Cardiology Service
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jesus martinez-alday
Hospital Universitario Basurto Servicio de Cardiología
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Abstract

Introduction: Cryoballoon ablation (CBA) has become a standard treatment for paroxysmal atrial fibrillation (PaAF) but limited data is available for outcomes in patients with persistent atrial fibrillation (PeAF). Methods: We analyzed the first 944 patients included in the Spanish Prospective Multi-center Observation Post-market Registry to compare characteristics and outcomes of patients undergoing CBA for PeAF versus PaAF. Results: A total of 944 patients (57.8±10.4 years; 70.1% male) with AF (27.9% persistent) were prospectively included from 25 centers. PeAF patients were more likely to have structural heart disease (67.7 vs 11.4%; p<0.001) and left atrium dilation (72.6 vs 43.3%; p<0.001). CBA of PeAF was less likely to be performed under general anesthesia (10.7 vs 22.2%; p<0.001), with an arterial line (32.2 vs 44.6%; p<0.001) and assisted transeptal puncture (11.9 vs 17.9%; p=0.025). During an application, PeAF patients had a longer time to -30°C (35.91±14.20 vs 34.93±12.87 sec; p=0.021) and a colder balloon nadir temperature during vein isolation (-35.04±9.58 vs -33.61±10.32ºC; p=0.004), but received fewer bonus freeze applications (30.7 vs 41.1%; p<0.001). There were no differences in acute pulmonary vein isolation and procedure-related complications. Overall, 76.7% of patients were free from AF recurrences at 15-month follow-up (78.9% in PaAF vs. 70.9% in PeAF; p=0.09). Conclusions: Patients with PeAF have a more diseased substrate, and CBA procedures performed in such patients were more simplified, although longer/colder freeze applications were often applied. The acute efficacy/safety profile of CBA was similar between PaAF and PeAF patients, but long-term results were better in PaAF patients.