loading page

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

Corresponding Author:[email protected]

Author Profile
Jesus Jimenez
Hospital del Mar Institute for Medical Research
Author Profile
Julio Martí-Almor
Hospital del Mar Institute for Medical Research
Author Profile
Jorge Toquero
Puerta de Hierro University Hospital of Majadahonda
Author Profile
Jose Ormaetxe
Hospital de Basurto
Author Profile
Alberto Barrera-Cordero
Hospital Universitario Virgen de la Victoria
Author Profile
Arcadi García-Alberola
Virgen de la Arrixaca University Hospital
Author Profile
Jose Manuel Rubio
Fundacion Jimenez Diaz-UTE
Author Profile
PABLO MORIÑA-VÁZQUEZ
Hospital Juan Ramon Jimenez
Author Profile
Carlos Grande
Son Espases University Hospital
Author Profile
Maria Fe Arcocha
Hospital de Araba
Author Profile
Rafael Peinado
La Paz University Hospital
Author Profile
Rocio Cozar
Virgen Macarena University Hospital
Author Profile
Julio Salvador Hernandez Afonso
Hospital Universitario Nuestra Senora de la Candelaria
Author Profile
Luisa Perez Alvarez
Complexo Hospitalario Universitario A Coruna
Author Profile
Larraitz Gaztañaga
Basurto University Hospital
Author Profile
Angel Ferrero
Quiron Valencia Clinic
Author Profile
Ricardo Ruiz Granell
Quiron Valencia Clinic
Author Profile
Roger Villuendas
Germans Trias i Pujol University Hospital Cardiology Service
Author Profile
jesus martinez-alday
Hospital Universitario Basurto Servicio de Cardiología
Author Profile

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.
22 Feb 2022Published in Journal of Clinical Medicine volume 11 issue 5 on pages 1166. 10.3390/jcm11051166