Heart Care Info - Heart Disease Prevention & Treatment

201 Pulmonary vein isolation by cryoballoon ablation in patients with paroxysmal atrial fibrillation: efficacy, safety and predictors of arrhythmia recurrence

A Guiot, A Savoure, B Godin, A Cribier... - Archives of ..., 2011 - Elsevier Thirty-two of the 44 patients (73%) had complete isolation of all PVs. Out of 176 treated veins, 164 were completely isolated (93%). The number of balloon applications per vein was 2.3 0.8. The mean procedure and fluoroscopy times were 163.4 36.2 and 32.0 11.7 ...

Radiofrequency (RF) catheter ablation has emerged as an effective treatment for patients with drug-refractory atrial fibrillation (AF). The objective of this study is to evaluate the efficacy and safety of pulmonary vein isolation (PVI) with a cryoballoon catheter (Arctic Front, Cryocath, Quebec, Canada).

In 44 consecutive patients with symptomatic paroxysmal AF (28 males, age 57 +/ 11 years), circumferential PVI was performed using a cryoballoon catheter. Before discharge, all patients were subjected to 24-hour Holter electrocardiograms, echocardiography, and esophageal endoscopy. Magnetic resonance imaging was performed prior to and 3 months after ablation. At a mean follow up of 4.3 +/ 1.2 months after ablation, patients underwent clinical review and 24-hour Holter electrocardiograms. Clinical and demographic variables were analyzed via logistic regression to assess for predictors of recurrence.

Thirty-two of the 44 patients (73%) had complete isolation of all P Vs. Out of 176 treated veins, 164 were completely isolated (93%). The number of balloon applications per vein was 2.3 0.8. The mean procedure and fluoroscopy times were 163.4 36.2 and 32.0 11.7 min, respectively. Eight patients had evidence of mild pericardial effusions requiring no further treatment. Five patients (11.4%) experienced phrenic nerve palsy, 4 of which resolved immediately and one at 2 weeks. Follow up at 4.3 +/ 1.2 months showed freedom from AF in 28 patients (63.6%) and freedom from AF without antiarrhythmic drug therapy in 19 patients (43.2%). Of all clinical variables analyzed, only early recurrence of AF within 4 days post ablation was associated with long term AF recurrence (p = 0.002; OR = 0.11; CI = [0.018 0.524]).