Center experience does not influence long-term outcome and peri-procedural complications after cryoballoon ablation of paroxysmal atrial fibrillation: Data on 860 patients from the real-world multicenter observational project

Landolina, Maurizio; Arena, Giuseppe; Iacopino, Saverio; Verlato, Roberto; Pieragnoli, Paolo; Curnis, Antonio; Lunati, Maurizio; Rauhe, Werner; Senatore, Gaetano; Sciarra, Luigi; Molon, Giulio; Agricola, Pietro; Padeletti, Luigi; Tondo, Claudio

doi:10.1016/j.ijcard.2018.07.051

Cited by 22 publications

(25 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Within the 1STOP data repository, there are 164 patients treated with CB‐1, 4111 patients treated with CB‐2, 221 patients treated with CB‐3, and 276 patients treated with CB‐4. Using the last 120 patients enrolled for CB‐2, CB‐3, and CB‐4; the data collection was made outside of a well‐described CB catheter learning curve and more than 50% of the data were examined for each of the three later cohorts (CB‐2, CB‐3, and CB‐4).…”

Section: Resultsmentioning

confidence: 99%

“…Patients with AF who had undergone CB‐PVI (using CB‐1, −2, −3, or −4) in 47 Italian institutions from April 2012 to April 2019 were prospectively followed through in‐hospital visits according to each center's clinical practice through the framework of the Italian ClinicalService and 1STOP project . In brief, the project (Clinical Trial Registration: NCT01007474) is a prospective examination of CB ablations conducted in Italian cardiology centers.…”

Section: Methodsmentioning

confidence: 99%

“…The description of the CB catheter ablation procedure has been previously published . In general, patients were treated with general anesthesia or conscious sedation during the procedure, and a heparin bolus was delivered at the time of the transseptal needle puncture into the left atrium.…”

Section: Methodsmentioning

confidence: 99%

“…Consequently, we examined patients that were treated for AF using the CB‐1 vs CB‐2 vs CB‐3 vs CB‐4. These four cohorts were compared in a real‐world multicenter examination of procedural safety and efficacy utilizing a retrospective review of data held within the 1STOP Italian registry project …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real‐world multicenter experience of 1STOP

Iacopino

Pieragnoli

Arena

et al. 2019

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

Introduction Four generations of the cryoballoon (CB) catheter were retrospectively evaluated in a real‐world examination of patients with atrial fibrillation (AF). Methods and Results Four hundred eighty patients (27% female and 60 ± 10 years) suffering from AF, underwent pulmonary vein (PV) ablation with one‐of‐four generations of the CB catheter. The total cohort was divided into four groups of patients: 120 with first‐generation (CB‐1); 120 with second‐generation (CB‐2); 120 with third‐generation (CB‐3); and 120 with fourth‐generation (CB‐4). Equal group sizes were achieved by examining the last 120 patients treated in each cohort, attempting to minimize the effect of a learning curve between the generations of CB catheter. Baseline clinical and patient characteristics were similar between the four cohorts, excepting age and the number of tested antiarrhythmic drugs. Procedure, fluoroscopy, and left atrial dwell times were significantly lower in the CB‐4 cohort compared to previous generations of the CB catheters, while the acute procedural success rate was comparable across all catheter groups (>99%). Total acute procedural complications were low (2.5%), and acute complications were comparable within the CB‐2, CB‐3, and CB‐4 groups (0.8% reported in each cohort). The rate of time‐to‐isolation (TTI) visualization increased with later generations of the CB catheters. Conclusions The novel CB‐4 achieved significantly faster procedural ablation times in comparison to the previous generations, while still maintaining a low rate of acute complications. Also, the rate of TTI visualization was observed to be higher with the CB‐4 catheter. Further long‐term evaluation is necessary, including an assessment of AF recurrence and PV reconnection(s).

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real‐world multicenter experience of 1STOP

Iacopino

Pieragnoli

Arena

et al. 2019

Cardiovasc electrophysiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…decreased by the use of the CB4 catheter, probably due to a greater ability to record PV electrograms and real-time TTE that enhance the procedural efficacy by reducing the number of total cryoapplications and as a consequence the total procedure and ablation time. From previous reports, procedural times in cryoablation PVI largely ranged from 60 to 160 minutes7,[17][18][19][20] and depended on several factors, including: the experience of the operator, the volume of caseloads of the center, the choose PVI protocol in terms of number and durations of freezes, and the method of verification of PV reconnections.…”

mentioning

confidence: 99%

Acute outcome after a single cryoballoon ablation: Comparison between Arctic Front Advance and Arctic Front Advance PRO

Moltrasio

Sicuso

Fassini

et al. 2019

Pacing Clinical Electrophis

Self Cite

View full text Add to dashboard Cite

Background:The novel fourth-generation cryoballoon (CB4) potentially allows for enhanced catheter maneuverability and more frequent capture of pulmonary vein (PV) potentials which can be used to monitor real-time PV isolation (PVI). The aim of our study is to compare the acute procedural endpoints between the CB4 and second-generation cryoballoon (CB2). Methods:A single-center retrospective chart review was used to examine 50 consecutive patients with drug-refractory atrial fibrillation undergoing CB4-based PVI. Procedural data and acute success of these patients were compared to 50 propensity-matched controls who underwent cryoballoon ablation procedure using CB2. Results:Procedures performed with the CB4 showed significant shorter fluoroscopy time (14.8 ± 5.5 vs 18.0 ± 6.5 minutes, P = .04), shorter procedure time (58.3 ± 15.7 vs 65.3 ± 21 minutes, P = .13), and shorter total ablation time (10.8 ± 1.5 vs 13.8 ± 1.9 minutes, P = .42). The real-time PVI visualization rate was 33.3% in the CB2 group and 74.7% in the CB4 group (P < .001). CB4 was correlated to significant increase of acute real-time recordings with regard to all the single PV (left superior PV: 58% vs 84%, P = .02; left inferior PV: 26% vs 71%, P = .001; right superior PV 29% vs 61%, P = .01; and right inferior PV 19% vs 58%, P = .002). Conclusion:The CB4 was more often able to capture real-time recordings of PV potentials and the subsequent acute PV isolation. K E Y W O R D Satrial fibrillation, catheter ablation, cryoablation, cryoballoon catheter, pulmonary vein isolation INTRODUCTIONAs a cornerstone technique, pulmonary vein isolation (PVI) is the primary target for catheter ablation in patients with drug-refractory symptomatic paroxysmal and persistent atrial fibrillation (AF). 1 Furthermore, the cryoballoon (CB) catheter is a well-described tool that has achieved good procedural results with a freedom from AF recurrence that is similar to radiofrequency ablation catheters. 2 Particularly, since 2012, the second-generation CB (CB2, Artic Front Advance, Medtronic, Inc., Minneapolis, MN, USA) has been described as a catheter with a high procedural success rate and durability of clini-cal outcomes in the treatment of patients with AF. [3][4][5][6][7] Recent technical changes were completed to improve the CB catheter in terms of maneuverability and pulmonary vein (PV) signal recordings during PVI.The resulting fourth-generation CB (CB4, Artic Front Advance PRO, Medtronic, Inc.) is characterized by a shorter tip (8-mm distal tip versus 13.5-mm tip of the traditional balloon, a 40% reduction) that can potentially facilitate better visualization of PV signals (Figure 1).The real-time visualization of PV potentials allows for a patienttailored ablation strategy. Specifically, the visualization of timeto-effect (TTE; defined as the duration of freeze until acute circumferential cellular electrical dormancy is achieved) can be 890

show abstract

Cryoballoon ablation of atrial fibrillation is effectively feasible without previous imaging of pulmonary vein anatomy: insights from the 1STOP project

Sagone

Iacopino

Pieragnoli

et al. 2019

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Center experience does not influence long-term outcome and peri-procedural complications after cryoballoon ablation of paroxysmal atrial fibrillation: Data on 860 patients from the real-world multicenter observational project

Cited by 22 publications

References 33 publications

A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real‐world multicenter experience of 1STOP

A comparison of acute procedural outcomes within four generations of cryoballoon catheters utilized in the real‐world multicenter experience of 1STOP

Acute outcome after a single cryoballoon ablation: Comparison between Arctic Front Advance and Arctic Front Advance PRO

Cryoballoon ablation of atrial fibrillation is effectively feasible without previous imaging of pulmonary vein anatomy: insights from the 1STOP project

Contact Info

Product

Resources

About