Veins without real-time pulmonary vein isolation during cryoballoon ablation strongly predict long-term atrial fibrillation recurrence

Autor: Y De Greef, I Buysschaert, F Cecchini, D Sofianos, K Kupics, V Varnavas, E Stroker, B Schwagten, J De Cocker, M Tijskens, B Adriaenssens, M Wolf, J P Abugattas
Rok vydání: 2023
Předmět:
Zdroj: Europace. 25
ISSN: 1532-2092
1099-5129
DOI: 10.1093/europace/euad122.097
Popis: Funding Acknowledgements Type of funding sources: None. Background Absence of real-time PV isolation (PVI) by the Achieve catheter occurring in 15 to 40% of the veins during cryoballoon ablation (CBA) of atrial fibrillation (AF) raises doubt about adequate PVI. Purpose To determine whether veins without real-time PVI are predictive of long-term clinical outcome. Methods and Results 803 of 1000 consecutive AF patients (mean age 64±10 years, 68% males) treated with CBA were followed for 3 years. Clinical success defined as freedom of documented AF at 3 years was achieved in 65.3% of the patients. The cohort was divided in 4 groups according to the number of PVs with real-time PVI: all veins (N=252(31,4%)), 3 (N=255(31,8%)), 2 (N=159(19,8%)) and 0-1 vein (N=137(17,1)). A vein without real-time PVI was associated with AF recurrence (HR=1.275; 95%CI 1.134-1.433; p Conclusion Veins without real-time PVI during CBA independently predict long-term AF recurrence with increasing AF recurrence per increase in veins without real-time PVI. A trend towards a higher reconnection rate in veins without real-time PVI suggest incomplete PVI or a less efficacious freeze resulting in less durable PVI.
Databáze: OpenAIRE