Aims: The purpose of this study was to determine efficacy of pulmonary vein isolation (PVI) using the 28 mm cryoballoon (CB) in patients with persistent atrial fibrillation (AF). Superior acute and 1-year outcome has been demonstrated following PVI, using the second-generation CB in patients with paroxysmal AF. Data on the outcome in patients with persistent AF are sparse.
Methods and results: Forty-nine patients (20 female, mean age 63 ± 10 years, mean left atrial diameter 46 ± 5 mm) with persistent AF [median AF duration since first diagnosis: 48 (20:192) months] underwent second-generation 28 mm CB-based PVI. The freeze cycle duration was set at 240 s. After successful PVI, a bonus freeze cycle of 240 s was applied in the first 11/49 (22%) patients, and no bonus freeze cycle was used in the remaining 38/49 (78%) patients. Follow-up (FU) was based on outpatient clinic visits at 3, 6, and 12 months, which included Holter electrocardiograms and telephone interviews. Recurrence was defined as an episode of symptomatic and/or documented atrial tachyarrhythmia >30 s beyond the 3-month blanking period. A total of 193 pulmonary veins (PVs) were identified and 193/193 (100%) PVs were successfully isolated. No phrenic nerve paralysis occurred. Follow-up was obtained in 49/49 (100%) patients with a mean FU duration of 416 ± 178 days. After the 3-month blanking period, antiarrhythmic medication was discontinued in 33/49 (67%) patients. Thirty-four of 49 (69%) patients remained in stable sinus rhythm.
Conclusions: In patients with persistent AF, use of the second-generation 28 mm CB was associated with a 69% 1-year clinical success rate.
Keywords: Cryoballoon; Long-term follow-up; Persistent atrial fibrillation; Pulmonary vein isolation.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.