Three-Year Clinical Outcome After 2nd-Generation Cryoballoon-Based Pulmonary Vein Isolation for the Treatment of Paroxysmal and Persistent Atrial Fibrillation　- A 2-Center Experience.
Pulmonary vein isolation (PVI) using the 2nd-generation cryoballoon (CB2) for the treatment of atrial fibrillation (AF) has demonstrated encouraging acute and mid-term results. However, follow-up data on outcomes beyond 1 year are sparse. We investigated the 3-year outcome after PVI using the CB2.



100 patients with paroxysmal (PAF, 70/100 [70%] patients) or persistent AF (pAF, 30/100 [30%] patients) underwent CB2-based PVI in 2 experienced centers in Germany. Freeze-cycle duration was 240 s. After successful PVI a bonus freeze-cycle of the same duration was applied in the first 71 patients but was omitted in the following 29 patients. Phrenic nerve palsy occurred in 3 patients (3%); 2 patients were lost to follow-up. After a median follow-up of 38 (29-50) months, 59/98 (60.2%) patients remained in stable sinus rhythm (PAF: 48/70 (69%), pAF: 11/28 (39%) P=0.0084). In 32/39 (77%) patients with arrhythmia recurrence, a second ablation procedure using radiofrequency energy was conducted. Persistent PVI was noted in 76/125 (61%) PVs. After a mean of 1.37±0.6 procedures and a median follow-up of 35 (25-39) months, 77/98 (78.6%) patients remained in stable sinus rhythm (PAF: 56/70 (80%), pAF: 20/28 (71%), P=0.0276).



CB2-based PVI resulted in a 60.2% single-procedure and a 78.6% multiple-procedure success rate after 3 years. Repeat procedures demonstrated a high rate of durable PVI.
Department of Cardiology, Asklepios Klinik St. Georg.
Christian-H
CH
Heeger
Department of Cardiology, Asklepios Klinik St. Georg.|Division of Cardiology, University of Illinois at Chicago.
Erik
E
Wissner
Department of Cardiology, Asklepios Klinik St. Georg.
Milena
M
Knöll
Department of Cardiology, Asklepios Klinik St. Georg.
Benedikt
B
Knoop
Department of Cardiology, Asklepios Klinik St. Georg.
Bruno
B
Reissmann
Department of Cardiology, Asklepios Klinik St. Georg.
Shibu
S
Mathew
Department of Cardiology, Asklepios Klinik St. Georg.
Christian
C
Sohns
Department of Cardiology, Asklepios Klinik St. Georg.
Christine
C
Lemes
Department of Cardiology, Asklepios Klinik St. Georg.
Tilman
T
Maurer
Department of Cardiology, Asklepios Klinik St. Georg.
Francesco
F
Santoro
Department of Cardiology, Asklepios Klinik St. Georg.
Johannes
J
Riedl
Department of Cardiology, Asklepios Klinik St. Georg.
Osamu
O
Inaba
Department of Cardiology, Asklepios Klinik St. Georg.
Thomas
T
Fink
Department of Cardiology, Asklepios Klinik St. Georg.
Laura
L
Rottner
Department of Cardiology, Asklepios Klinik St. Georg.
Peter
P
Wohlmuth
Department of Cardiology, Asklepios Klinik Harburg.
Britta
B
Goldmann
Department of Cardiology, Asklepios Klinik St. Georg.
Feifan
F
Ouyang
Department of Cardiology, Asklepios Klinik St. Georg.
Karl-Heinz
KH
Kuck
Department of Cardiology, Asklepios Klinik St. Georg.
Andreas
A
Metzner
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery; D012008:Recurrence
Atrial fibrillation; Cryoballoon; Long-term follow-up; Pulmonary vein isolation