Single 3-Minute versus Double 4-Minute Freeze Strategy for Second-Generation Cryoballoon Ablation: A Single-Center Experience

Autor:	F.H.R.S. Carlo De Asmundis M.D., Burak Hunuk, Pedro Brugada, Giannis Baltogiannis, Juan Sieira-Moret, Ebru Hacioglu, Giuseppe Ciconte, Giacomo Di Giovanni, Gian-Battista Chierchia, Giacomo Mugnai, Erwin Ströker, Yukio Saitoh, Ghazala Irfan, Giulio Conte, Vedran Velagic
Rok vydání:	2016
Předmět:	medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Retrospective cohort study Atrial fibrillation 030204 cardiovascular system & hematology medicine.disease Ablation Single Center Cryosurgery Pulmonary vein Surgery 03 medical and health sciences 0302 clinical medicine Physiology (medical) medicine Fluoroscopy 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Chi-squared distribution
Zdroj:	Journal of Cardiovascular Electrophysiology. 27:796-803
ISSN:	1045-3873
DOI:	10.1111/jce.12986
Popis:	Single 3 vs. Double 4 Strategy in CB ablationIntroduction Second-generation cryoballoon (CB-Adv) ablation is highly effective in achieving pulmonary vein isolation (PVI) with promising mid-term clinical outcome. However, the ideal freezing strategy is still under debate. The aim of this study was to assess the efficacy of a single 3-minute approach compared to the conventional 4-minute plus bonus application using CB-Adv. Methods and Results One hundred and sixty patients (67% male; mean age 58.0 ± 13.3 years) underwent PVI using CB-Adv for paroxysmal atrial fibrillation (PAF). Among 160 patients, 80 received a single 3-minute approach (3-mns group), while the remaining 80 conventional 4-minute plus bonus-freeze (4-mns group). Mean procedure and fluoroscopy times were 90.6 ± 15.8 and 18.3 ± 6.9 in the 4-mns group, 75.2 ± 17.1 and 13.5 ± 8.7 in the 3-mns group (P < 0.001, respectively). First-freeze isolation rate was 91.6% in the 4- versus 90.6% in the 3-mns group (P = 0.78). Persistent phrenic nerve palsy (PNP) occurred in 6/80 (3.5%) in the 4-mns group and 4/80 in the 3-mns group (P = 0.75). The overall freedom from ATas 2 years after the procedure was 78.1% (125/160): 77.5% (62/80 patients) in the 3-mns and 78.8% (63/80 patients) in the 4-mns group (P = 0.82). In multivariate analysis, time to PVI and nadir temperature independently predicted ATa recurrences (P < 0.001). Conclusions CB-Adv ablation for PAF is highly effective, resulting in 78% 2-year freedom from arrhythmic recurrences. A “single 3-minute strategy” showed equal efficacy as compared to the conventional 4-minute plus bonus freeze approach at 2-year follow-up, providing shorter procedure and fluoroscopy time. Nadir temperature and time to PVI were predictors of arrhythmic recurrences. “Bonus-freeze” strategy might be unnecessary.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::b4651dbf2b585eec8b8d1781a3dd3ea1 https://doi.org/10.1111/jce.12986 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.