Catheter Ablation for Atrial Fibrillation in Patients ≤30 Years of Age

Safety and efficacy of cryoablation for atrial fibrillation in young patients: A multicenter experience in the 1STOP project

“…Transient phrenic nerve paralysis (1.2%) was lower than that reported in recent large studies with the second‐generation CB (Ciconte et al reporting 8% and Aryana et al reporting 7.6%), 17,18 and only one patient suffered from an unresolved phrenic nerve palsy during the study follow‐up period. Overall, our observations support previous data about the safety of PVI in young patients 7–11 …”

“…The long‐term efficacy of CB‐PVI observed in our analysis (freedom from AF recurrence is 88.9% at the 12‐month follow‐up and 72.4% at the 36‐month follow‐up) overlaps that of Moran et al, who reported a freedom from AF relapse of 88% after a median follow‐up of 18 ± 10 months in a young cohort of patients <40 years 8 . In other series including RF‐ and CB‐PVI, freedom from AF recurrence after a single procedure varied from 60% to 85% after 12 to 36 months of follow‐up 6,7,10,11 . Our incidence rate of AF relapse of 9.29 for 100 patient‐years, overlaps the results of Saguner et al, who reported a 5‐year arrythmia‐free survival of 44% in a very young cohort of 85 patients (age < 35 years) 9 …”

“…To date, little is known about the age‐dependent differences regarding the outcomes of CB‐PVI, and there is a lack of data investigating the longer‐term follow‐up of young patients. Consequently, only a few studies have investigated the clinical outcomes of catheter ablation in young patients 6–11 . Thus, the aim of this analysis was to prospectively compare efficacy and safety of CB‐PVI for patients with AF between a cohort of young (≤45 years) and middle‐aged (60–65 years) patients and to evaluate the predictors of AF recurrence after CB‐PVI in a multicenter Italian clinical Project.…”

Cryoballoon for heart failure: Time to consider earlier

“…The “Fire and Ice” trial proved the noninferiority of cryoballoon ablation (CB‐2) to RF‐PVI in patients with paroxysmal AF (PAF) 9 . Cryoballoon ablation has been found to have high procedural success and shorter procedural duration, high durability of PVI, and convincing clinical results in various clinical conditions 10‐13 . With its unique design, CB‐2 modifies atrial substrate especially in posterior LA wall, which may increase clinical success beyond durable PVI 10 .…”

“…9 Cryoballoon ablation has been found to have high procedural success and shorter procedural duration, high durability of PVI, and convincing clinical results in various clinical conditions. [10][11][12][13] With its unique design, CB-2 modifies atrial substrate especially in posterior LA wall, which may increase clinical success beyond durable PVI. 10 In this issue of the Journal of Cardiovascular Electrophysiology, Dr.…”