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- Title
Outcome in patients with left common pulmonary vein after cryoablation with second‐generation cryoballoon.
- Authors
Beiert, Thomas; Lodde, Pia C.; Linneborn, Lutz P. T.; Werner, Jessica; Prinz, Lisa; Stöckigt, Florian; Linhart, Markus; Lickfett, Lars; Nickenig, Georg; Schrickel, Jan W.; Andrié, René P.
- Abstract
Abstract: Background: Pulmonary vein isolation (PVI) has become a widely accepted therapy in patients suffering from symptomatic atrial fibrillation (AF). Hypothesis: AF‐free survival differs in patients with left common pulmonary vein (LCPV) after PVI with second‐generation cryoballoon. Methods: We included patients scheduled for first PVI for paroxysmal or persistent AF. Symptomatic and/or documented arrhythmia episodes (>30 seconds) were defined as AF recurrence, excluding a 3‐month blanking period. Results: We observed a LCPV in 37 of 270 consecutive patients (13.7%). Analyses were performed in a 1:1 propensity score matched cohort of 68 patients. During a median follow‐up of 77.0 weeks, 37 patients (54.4%) had recurrent AF. The prevalence of LCPV was numerically higher in patients with AF recurrence (62.2% vs 35.5%, P = 0.051) and Kaplan‐Meier analysis showed lower AF‐free survival in patients with existence of a LCPV (P = 0.028). At 1‐year follow‐up, 70.6% of patients without versus 55.1% of patients with LCPV were free of AF. Multivariate Cox regression analysis revealed presence of a LCPV (hazard ratio [HR]: 2.996), chronic heart failure (HR: 3.423), and mitral regurgitation > I° (HR: 2.571) as predictors of AF recurrence. Conclusion: Patients with LCPV had significantly reduced AF‐free survival after ablation with the second‐generation cryoballoon, despite similar acutely successful PVIs.
- Subjects
ATRIAL fibrillation treatment; PULMONARY veins; TREATMENT effectiveness; CRYOSURGERY; REGRESSION analysis; PROPORTIONAL hazards models; KAPLAN-Meier estimator; ANATOMY
- Publication
Pacing & Clinical Electrophysiology, 2018, Vol 41, Issue 1, p22
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.13247