Long-term outcomes in this study suggest that the pulmonary vein isolation using the cryoballoon technique is relatively an effective method especially in the treatment of paroxysmal atrial fibrillation.

No abstract

Objectives Prolongation of QRS (≥ 120 ms) in patients with heart failure (HF) is associated with higher all-cause mortality than in those with narrow QRS. The aim of our study was to compare the survival of patients with HF and wide QRS after cardiac resynchronization therapy (CRT) with survival of HF patients with narrow QRS and to assess factors predictive of non-response to CRT. Methods We enrolled 680 patients with advanced HF and optimal pharmacologic therapy. All patients were assigned according to duration of QRS complex and implanted device. We acquired two groups. A first group, patients with wide QRS and implanted CRT-D (CRT-D group, n = 354) and a second group, patients having narrow QRS and implanted single/dual chamber ICD (ICD group, n = 326). The primary outcome was death from any cause. The response to CRT was defined as an increase of EF at least by 5% and/or reduction of LVEDD at least by 10%. Results The primary outcome was reached by 84 (23.7%) patients in the CRT-D group and 69 (21.2%) patients in the ICD group. We did not find a statistically significant difference in survival rate between the CRT-D and ICD group [P = 0.44; hazard ratio (HR) 1.132]. Conclusion Survival of patients with HF and wide QRS after CRT implantation is comparable to those with HF and narrow QRS. Coronary artery disease and QRS width less than 145 ms increase risk of non-response to CRT 2.2 and 2.9 times, respectively.

OBJECTIVES AND BACKGROUND: Studies assessing the unicentric and prospective comparison of effi cacy of cryoballoon pulmonary vein isolation in idiopathic and non-idiopathic atrial fi brillation (AF) patients are missing. The aim of this study was to compare a single procedural outcome in these subgroups of AF patients. METHODS: A total of 208 patients with drug resistant AF were included in this study. Among them, 36 patients had idiopathic AF and 172 patients had non-idiopathic AF. The effi cacy endpoint was freedom from any atrial arrhythmia lasting > 30 s after a 3-months blanking period. RESULTS: The freedom from atrial arrhythmias without antiarrhythmic drugs after 1 and 3 years of follow-up, respectively, was 85.2 % and 70.4 % in patients with idiopathic AF; and 64.6 % and 39.9 % in patients with non-idiopathic AF (p = 0.021). Moreover, the success rate when analysing only paroxysmal AF patients after 1 and 3 years of follow-up, respectively, was 95.7 % and 82 % in patients with idiopathic AF; and 72.6 % and 47 % in patients with non-idiopathic AF (p = 0.022). CONCLUSIONS: A single cryoballoon pulmonary vein isolation was more effective in preventing atrial arrhythmias relapses in idiopathic AF patients compared to non-idiopathic AF patients. The best effi cacy outcomes were observed in patients with paroxysmal idiopathic AF (Tab. 5, Fig. 2, Ref. 25).

The hs-cTnI can be an useful biomarker with prognostic value in patients receiving CRT.