Open AccessCryoballoon ablation of the left atrial posterior wall reduces recurrence of persistent atrial fibrillation in patients with non‐paroxysmal atrial fibrillation
Author(s) -
Shigeta Takatoshi,
Yamauchi Yasuteru,
Sagawa Yuichiro,
Oda Atsuhito,
Tachibana Shinichi,
Sudo Koji,
Nakamura Rena,
Okishige Kaoru,
Goya Masahiko,
Sasano Tetsuo
Publication year - 2021
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12654
Subject(s) - medicine , ablation , atrial fibrillation , pulmonary vein , cardiology , paroxysmal atrial fibrillation , cryoablation , atrial tachycardia , catheter ablation
Background This study aimed to clarify the clinical outcomes of cryoballoon ablation of the left atrial (LA) posterior wall (LAPW), including the LA roof, in patients with non‐paroxysmal atrial fibrillation (AF). Methods We analyzed the outcomes of 284 patients with non‐paroxysmal AF, of whom 210 underwent the cryoballoon ablation of the LAPW, including the LA roof, in addition to pulmonary vein isolation with a cryoballoon. Results Complete conduction block at the LA roof was obtained in 95.7% (201/210) of patients, and LAPW was isolated in 83.3% (130/156) of patients. Over 372 (range, 208–477) days of follow‐up, atrial arrhythmia recurrence was observed in 84 (29.6%) patients, and atrial tachycardia (AT) recurrence accounted for 27.4% of cases. The prevalence of LA roof cryoballoon ablation was significantly higher in patients without recurrence than in those with recurrence (78.6% vs. 63.1%, respectively; p = .01), especially those with persistent AF recurrence (77.0% vs. 55.0%, p = .01). No significant difference was found in the prevalence of AT recurrence between patients who had undergone additional LAPW ablation and those who had not. Durable LA roof lesions were confirmed in 29 (72.5%) of 40 patients who underwent redo ablation. Conclusions Cryoballoon ablation of the LAPW leads to a sufficient acute success rate of complete conduction block and durable lesions of the LA roof without increasing AT recurrence risk. The prevalence of persistent AF recurrence decreases after additional cryoballoon ablation of the LAPW in patients with non‐paroxysmal AF.