Aims: Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) is mainly reserved for patients with drug-refractory or drug-intolerant symptomatic atrial fibrillation. We evaluated a large cohort of patients treated in a real-world setting and examined the safety and efficacy profile of CBA when applied as a first-line treatment for atrial fibrillation. Methods: In total, 249 patients (23% women; 56 ± 13 years; mean left atrial diameter 41 ± 7 mm; 73.5% paroxysmal atrial fibrillation; and 26.5% persistent atrial fibrillation) underwent an index PVI by CBA. Data were collected prospectively in the framework of the 1STOP ClinicalService project, involving 26 Italian cardiology centers. Results: Median procedure and fluoroscopy times were 90.0 and 21.0 min, respectively. Acute procedural success was 99.8%. Acute/periprocedural complications were observed in seven patients (2.8%), including: four transient diaphragmatic paralyses, one pericardial effusion (not requiring any intervention), one transient ischemic attack, and one minor vascular complication. The Kaplan--Meier freedom from atrial fibrillation recurrence was 86.3% at 12 months and 76% at 24 months. Seventeen patients (6.8%) had a repeat catheter ablation procedure during the follow-up period. At last follow-up, 10% of patients were on an anticoagulation therapy, whereas 6.8% were on an antiarrhythmic drug. Conclusion: In our multicenter real-world experience, PVI by CBA in a first-line atrial fibrillation patient population was well tolerated, effective, and promising. CBA with a PVI strategy can be used to treat patients with paroxysmal and persistent atrial fibrillation with good acute procedural success, short procedure times, and acceptable safety. Clinical trial registration: clinicaltrials.gov (NCT01007474).

First-line therapy: insights from a real-world analysis of cryoablation in patients with atrial fibrillation / M. Moltrasio, S. Iacopino, G. Arena, P. Pieragnoli, G. Molon, M. Manfrin, R. Verlato, L. Ottaviano, G. Rovaris, D. Catanzariti, L. Cipolletta, D. Nicolis, G. Cattafi, C. Tondo. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2027. - 22:8(2021 Aug), pp. 618-623. [10.2459/JCM.0000000000001176]

First-line therapy: insights from a real-world analysis of cryoablation in patients with atrial fibrillation

C. Tondo
Ultimo
2021

Abstract

Aims: Pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) is mainly reserved for patients with drug-refractory or drug-intolerant symptomatic atrial fibrillation. We evaluated a large cohort of patients treated in a real-world setting and examined the safety and efficacy profile of CBA when applied as a first-line treatment for atrial fibrillation. Methods: In total, 249 patients (23% women; 56 ± 13 years; mean left atrial diameter 41 ± 7 mm; 73.5% paroxysmal atrial fibrillation; and 26.5% persistent atrial fibrillation) underwent an index PVI by CBA. Data were collected prospectively in the framework of the 1STOP ClinicalService project, involving 26 Italian cardiology centers. Results: Median procedure and fluoroscopy times were 90.0 and 21.0 min, respectively. Acute procedural success was 99.8%. Acute/periprocedural complications were observed in seven patients (2.8%), including: four transient diaphragmatic paralyses, one pericardial effusion (not requiring any intervention), one transient ischemic attack, and one minor vascular complication. The Kaplan--Meier freedom from atrial fibrillation recurrence was 86.3% at 12 months and 76% at 24 months. Seventeen patients (6.8%) had a repeat catheter ablation procedure during the follow-up period. At last follow-up, 10% of patients were on an anticoagulation therapy, whereas 6.8% were on an antiarrhythmic drug. Conclusion: In our multicenter real-world experience, PVI by CBA in a first-line atrial fibrillation patient population was well tolerated, effective, and promising. CBA with a PVI strategy can be used to treat patients with paroxysmal and persistent atrial fibrillation with good acute procedural success, short procedure times, and acceptable safety. Clinical trial registration: clinicaltrials.gov (NCT01007474).
No
English
atrial fibrillation; catheter ablation; cryoballoon catheter; first-line therapy; One Shot TO Pulmonary vein isolation project; pulmonary vein isolation;
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Articolo
Esperti anonimi
Pubblicazione scientifica
ago-2021
23-mar-2021
Lippincott, Williams & Wilkins : Wolters Kluwer
22
8
618
623
6
Pubblicato
Periodico con rilevanza internazionale
pubmed
Aderisco
info:eu-repo/semantics/article
First-line therapy: insights from a real-world analysis of cryoablation in patients with atrial fibrillation / M. Moltrasio, S. Iacopino, G. Arena, P. Pieragnoli, G. Molon, M. Manfrin, R. Verlato, L. Ottaviano, G. Rovaris, D. Catanzariti, L. Cipolletta, D. Nicolis, G. Cattafi, C. Tondo. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2027. - 22:8(2021 Aug), pp. 618-623. [10.2459/JCM.0000000000001176]
reserved
Prodotti della ricerca::01 - Articolo su periodico
14
262
Article (author)
si
M. Moltrasio, S. Iacopino, G. Arena, P. Pieragnoli, G. Molon, M. Manfrin, R. Verlato, L. Ottaviano, G. Rovaris, D. Catanzariti, L. Cipolletta, D. Nicolis, G. Cattafi, C. Tondo
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/844858
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