BackgroundAtrial fibrillation (AF) is an uncommon arrhythmia in young adults without structural heart disease, and cryoballoon pulmonary vein isolation (CB-PVI) is an important therapeutic strategy for rhythm control in patients with drug-refractory AF. The aim of this analysis was to evaluate efficacy and safety of CB-PVI in a large cohort of young patients in comparison with middle-aged adults in a real-world setting. MethodsFrom 2012 to 2020, a total of 3033 patients with AF underwent CB-PVI and were followed prospectively in the framework of the 1STOP Clinical Service project, involving 34 Italian centers. Out of 3033 total 1STOP project subjects, a subgroup of 1318 patients were defined which included a YOUNG group (age <= 45 years; n = 368) and a MIDDLE-AGED group (age 60-65 years; n = 950). ResultsThe acute success rate of PVI did not differ between the two cohorts (99.9 +/- 1.3% vs. 99.8 +/- 3.2%, p = 0.415). There was no difference in procedural characteristics, and periprocedural complication rates were similar among the two cohort (1.9% vs. 2.3%, p = 0.646). The 12-month freedom from AF recurrence was 88.9% (95% confidence interval [CI]: 84.7-92.0) in the YOUNG cohort and 85.6% (95% CI: 82.9-88.0) in the MIDDLE-AGED group. At 36-month follow-up, freedom from AF recurrence was 72.4% (65.5%-78.2%) and 71.8% (67.7%-75.6%), respectively with no significant difference among groups (p = 0.550). ConclusionCB-PVI had similar efficacy and safety in YOUNG and MIDDLE-AGED patients. Younger age did not affect acute procedural results, complication rate, or AF recurrence after a single procedure.
Safety and efficacy of cryoablation for atrial fibrillation in young patients: A multicenter experience in the 1STOP project / E. Bertaglia, S. Iacopino, R. Verlato, G. Arena, P. Pieragnoli, C. Tondo, G. Molon, M. Manfrin, G.B. Perego, G. Rovaris, F. Rivezzi, M. Mantica, U. Startari, L. Sciarra. - In: CLINICAL CARDIOLOGY. - ISSN 1932-8737. - 46:2(2023 Feb), pp. 142-150. [10.1002/clc.23951]
Safety and efficacy of cryoablation for atrial fibrillation in young patients: A multicenter experience in the 1STOP project
C. Tondo;
2023
Abstract
BackgroundAtrial fibrillation (AF) is an uncommon arrhythmia in young adults without structural heart disease, and cryoballoon pulmonary vein isolation (CB-PVI) is an important therapeutic strategy for rhythm control in patients with drug-refractory AF. The aim of this analysis was to evaluate efficacy and safety of CB-PVI in a large cohort of young patients in comparison with middle-aged adults in a real-world setting. MethodsFrom 2012 to 2020, a total of 3033 patients with AF underwent CB-PVI and were followed prospectively in the framework of the 1STOP Clinical Service project, involving 34 Italian centers. Out of 3033 total 1STOP project subjects, a subgroup of 1318 patients were defined which included a YOUNG group (age <= 45 years; n = 368) and a MIDDLE-AGED group (age 60-65 years; n = 950). ResultsThe acute success rate of PVI did not differ between the two cohorts (99.9 +/- 1.3% vs. 99.8 +/- 3.2%, p = 0.415). There was no difference in procedural characteristics, and periprocedural complication rates were similar among the two cohort (1.9% vs. 2.3%, p = 0.646). The 12-month freedom from AF recurrence was 88.9% (95% confidence interval [CI]: 84.7-92.0) in the YOUNG cohort and 85.6% (95% CI: 82.9-88.0) in the MIDDLE-AGED group. At 36-month follow-up, freedom from AF recurrence was 72.4% (65.5%-78.2%) and 71.8% (67.7%-75.6%), respectively with no significant difference among groups (p = 0.550). ConclusionCB-PVI had similar efficacy and safety in YOUNG and MIDDLE-AGED patients. Younger age did not affect acute procedural results, complication rate, or AF recurrence after a single procedure.File | Dimensione | Formato | |
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