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. 2021 Aug 10;37(5):1287-1294.
doi: 10.1002/joa3.12614. eCollection 2021 Oct.

Repeat procedures for recurrent persistent atrial fibrillation: A propensity-matched score comparison between left atrial linear ablation with radiofrequency and posterior wall isolation with the cryoballoon

Antonio Bisignani  1   2 , Luigi Pannone  1 , Gezim Bala  1 , Shuichiro Kazawa  1 , Paul Calburean  1 , Ingrid Overeinder  1 , Cinzia Monaco  1 , Felicia Lipartiti  1 , Vincenzo Miraglia  1 , Sergio Rizzi  1 , Maysam Al Housari  1 , Joerelle Mojica  1 , Antanas Strazdas  1 , Thiago Guimarães Osório  1 , Juan Sieira  1 , Saverio Iacopino  1 , Alexandre Almorad  1 , Erwin Ströker  1 , Antonio Sorgente  1 , Pedro Brugada  1 , Carlo de Asmundis  1 , Gian-Battista Chierchia  1
Affiliations

Repeat procedures for recurrent persistent atrial fibrillation: A propensity-matched score comparison between left atrial linear ablation with radiofrequency and posterior wall isolation with the cryoballoon

Antonio Bisignani et al. J Arrhythm. .

Abstract

Aims: To evaluate the clinical outcome in patients undergoing repeat procedures for recurrent persistent atrial fibrillation following an index cryoballoon (CB-A) pulmonary vein isolation ablation on a mid-term follow-up of 12 months.

Methods: In this propensity score-matched comparison, 50 patients undergoing left atrial posterior wall isolation (LAPWI) with the CB-A were matched to 50 patients treated with additional linear ablation using radiofrequency catheter ablation (RFCA).

Results: Meantime to repeat the procedure was 9.74 ± 4.36 months. At 12 months follow-up freedom from atrial tachyarrhythmias (ATas) was achieved in 82% of patients in the LAPWI group and in 62% of patients in the linear ablation group (P = .03). Regression analysis demonstrated that relapses during the blanking period and LA dimensions were independent predictors of ATas recurrences following the repeat procedure.

Conclusion: LAPWI using CB-A is associated with a significantly higher freedom from atrial arrhythmias when compared with the RFCA mediated left atrial linear lesions on a mid-term follow-up of 12 months in patients with persAF undergoing a redo procedure.

Keywords: cryoballoon; left atrial posterior wall ablation; persistent atrial fibrillation; pulmonary vein isolation; radiofrequency ablation.

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Conflict of interest statement

GBC reports speaker fees for Medtronic, Biotronik, Biosense Webster, and Abbott; teaching honoraria from Medtronic and Biotronik; proctoring honoraria from Medtronic; AB is consultant for Biotronik; PB reports consulting fees and speaker honoraria from Medtronic; C.d.A. reports speaker fees for Medtronic, Biotronik, Biosense Webster, Abbott, and Boston Scientific; teaching honoraria from Medtronic, Biotronik, Abbott, and Boston Scientific; proctoring honoraria from Medtronic, Abbott, and Biotronik.

Figures

FIGURE 1
FIGURE 1
Voltage map of Left Atrium after posterior wall isolation using cryoballoon. The red region represents voltage <0.1 mV
FIGURE 2
FIGURE 2
Kaplan–Meier curves illustrating the cumulative freedom from recurrent atrial tachyarrhythmia after the 3‐month blanking period in LAPWI group (blue line) and in linear ablation group (green line)
See this image and copyright information in PMC

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