The long-term effect of thermal-guided second-generation cryoablation in paroxysmal and persistent atrial fibrillation

Abstract

Background Second-generation cryoballoon ablation is safe and effective in patients with paroxysmal (PAF) and persistent atrial fibrillation (AF). Objective This study aimed to assess the long-term clinical outcomes and freedom from AF in patients undergoing thermal-guided cryoablation without the use of an electrical mapping catheter. Methods All patients who had undergone thermal-guided second-generation cryoablation without electrical mapping between January 2015 and April 2018 at Eastbourne District General Hospital were retrospectively analysed. Success was defined as freedom from atrial arrhythmia lasting >30 s during the follow up period. Results The study included 234 patients with a mean age of 65.3 ± 10.6 years. There were 134 (57.0%) and 100 (42.7%) patients who had PAF and persistent AF respectively. Arrhythmia recurrence occurred in 38 of 134 (28.4%) PAF and 42 of 100 (42.0%) persistent AF patients after mean follow up of 40 ± 9.2 months. The patients with PAF had a significantly greater freedom from arrhythmia than patients with persistent AF (p = .040). The mean procedure time was 55.5 ± 12.2 min and the mean fluoroscopy time was 10.9 ± 4.8 min 73.5% of patients were discharged on the same day. Conclusion Thermal-guided cryoablation is feasible, safe and results in freedom from arrhythmia in the majority of paroxysmal and persistent AF patients in the long term. Randomised controlled trials are required to confirm the findings of this study.

Long‐term efficacy and safety of cryoballoon ablation of atrial fibrillation: A systematic review and meta‐analysis

“…The subjects included in the 19 studies were AF patients who underwent cryoablation, 7–25 of which eleven were prospective and the other eight were retrospective. The mean/median follow‐up period ranged from 38 to 124 months, incidence of recurrence and/or adverse events during the follow‐up period were provided.…”

“…A total of 4891 subjects were enrolled. The flow chart of literature inclusion is shown in Figure 1.The subjects included in the 19 studies were AF patients who underwent cryoablation,[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] of which eleven were prospective and the other eight were retrospective. The mean/median follow-up period ranged from 38 to 124 months, incidence of recurrence and/or adverse events during the follow-up period were provided.…”