Incidence and Significance of Early Recurrences of Atrial Fibrillation After Cryoballoon Ablation
| Autor: | Paul Khairy, Jason G. Andrade, Doug L. Packer, John W. Lehmann, Marc Dubuc, Laurent Macle, Jeremy N. Ruskin, Richard G. Holcomb |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Catheter ablation Kaplan-Meier Estimate Cryosurgery Cardiac Catheters Disease-Free Survival Recurrence Risk Factors Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Heart Atria Prospective Studies Cryoballoon ablation Proportional Hazards Models Chi-Square Distribution business.industry Incidence (epidemiology) Hazard ratio Atrial fibrillation Cryoablation Equipment Design Middle Aged medicine.disease Ablation Confidence interval Surgery Treatment Outcome Pulmonary Veins Multivariate Analysis North America Catheter Ablation Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation: Arrhythmia and Electrophysiology. 7:69-75 |
| ISSN: | 1941-3084 1941-3149 |
| DOI: | 10.1161/circep.113.000586 |
| Popis: | Background— Early recurrence of atrial fibrillation (ERAF) is common after radiofrequency catheter ablation for AF. We sought to determine the incidence and prognostic significance of ERAF after cryoballoon ablation. Moreover, the benefit of early reablation for ERAF after cryoballoon ablation is undetermined. Methods and Results— The Sustained Treatment of Paroxysmal Atrial Fibrillation (STOP AF) trial randomized 245 patients with paroxysmal AF to medical therapy versus cryoballoon-based pulmonary vein ablation. Patients were followed for 12 months. ERAF was defined as any recurrence of AF >30 seconds during the first 3 months of follow-up. Late recurrence (LR) was defined as any recurrence of AF >30 seconds between 3 and 12 months. Of the 163 patients randomized to cryoablation, 84 patients experienced ERAF (51.5%). The only significant factor associated with ERAF was male sex (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.03–4.61; P =0.041). LR was observed in 41 patients (25.1%), and was significantly related to ERAF (55.6% LR with ERAF versus 12.7% without ERAF; P P P =0.002). Conclusions— ERAF after cryoballoon ablation occurs in ≈50% of patients and is strongly associated with LR. Early reablation for ERAF is associated with excellent long-term freedom from recurrent AF. |
| Databáze: | OpenAIRE |
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