Regular atrial tachycardias following pulmonary vein isolation for paroxysmal atrial fibrillation: a retrospective comparison between the cryoballoon and conventional focal tip radiofrequency techniques

Purpose Occurrence of atrial tachycardias (ATs) following radiofrequency (RF) pulmonary vein (PV) isolation for the treatment of paroxysmal atrial fibrillation (PAF) is a frequent complication. Cryoballoon (CB) ablation might create more homogeneous and demarcated lesions than traditional point by p...

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Bibliographic Details
Published in:Journal of interventional cardiac electrophysiology 2015-03, Vol.42 (2), p.161-169
Main Authors: Juliá, Justo, Chierchia, Gian-Battista, de Asmundis, Carlo, Mugnai, Giacomo, Sieira, Juan, Ciconte, Giuseppe, Di Giovanni, Giacomo, Conte, Giulio, Baltogiannis, Giannis, Saitoh, Yukio, Wauters, Kristel, Irfan, Ghazala, Brugada, Pedro
Format: Article
Language:English
Subjects:
Aged
Atrial Fibrillation - diagnosis
Atrial Fibrillation - surgery
Cardiology
Catheter Ablation - methods
Cohort Studies
Cryosurgery - instrumentation
Cryosurgery - methods
Electrocardiography - methods
Female
Follow-Up Studies
Humans
Infant
Male
Medicine
Medicine & Public Health
Middle Aged
Postoperative Complications - diagnosis
Postoperative Complications - surgery
Pulmonary Veins - surgery
Reoperation - methods
Retrospective Studies
Risk Assessment
Tachycardia, Paroxysmal - diagnosis
Tachycardia, Paroxysmal - surgery
Treatment Outcome
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Summary:Purpose Occurrence of atrial tachycardias (ATs) following radiofrequency (RF) pulmonary vein (PV) isolation for the treatment of paroxysmal atrial fibrillation (PAF) is a frequent complication. Cryoballoon (CB) ablation might create more homogeneous and demarcated lesions than traditional point by point RF approach, hypothetically leading to a lower incidence of ATs. Our aim is to compare incidence and mechanism of regular ATs occurring after ablation of PAF by means of circumferential point by point RF vs CB ablation. Methods Two hundred eighty-six consecutive patients undergoing a first PV isolation procedure, as treatment for PAF, were included and followed up for 12 months. Point by point RF ablation was performed in 186 patients and CB ablation in the remaining 100. Among the last ones, first generation (CB-1) was used in 59 patients and second generation one (CB-2) in 41. Results Incidence of regular ATs was higher following RF PV isolation when compared with CB ablation (11.3 vs 3.0 %, P  = 0.028). When compared separately with RF ablation, both CB-1 and CB-2 presented lower incidences of ATs (5.1 and 0.0 %) but differences only remained significant for the CB-2 ( P  = 0.027). Conclusion Patients with PAF undergoing a first PV isolation procedure by means of CB ablation present a significantly lower incidence of ATs than those in which PV isolation is achieved by means of circumferential point by point RF ablation.
ISSN:1383-875X
1572-8595
DOI:10.1007/s10840-014-9961-4