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Clinical assessment of cryoballoon ablation in cases with atrial fibrillation and a left common pulmonary vein
Author(s) -
Shigeta Takatoshi,
Okishige Kaoru,
Yamauchi Yasuteru,
Aoyagi Hideshi,
Nakamura Tomofumi,
Yamashita Mitsumi,
Nishimura Takuro,
Ito Naruhiko,
Tsuchiya Yusuke,
Asano Mitsutoshi,
Shimura Tsukasa,
Suzuki Hidetoshi,
Kurabayashi Manabu,
Keida Takehiko,
Sasano Tetsuo,
Hirao Kenzo
Publication year - 2017
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.13267
Subject(s) - medicine , ablation , pulmonary vein , atrial fibrillation , cardiology , vein , surgery
Pulmonary vein isolation (PVI) using a cryoballoon (CB) is a useful tool for treating atrial fibrillation (AF); however, the clinical efficacy of the CB has never been fully investigated in patients with a left common pulmonary vein (LCPV). Methods and results Three hundred twenty‐four consecutive paroxysmal AF patients underwent PVI with a CB. Three‐dimensional computed tomography was performed in all patients before the ablation. The clinical outcomes of the AF ablation between patients with (Group A) and without an LCPV (Group B) were compared. An LCPV was observed in 27 (8%) patients. There were no significant differences in the procedure time (149 ± 45 min vs. 143 ± 40 min, respectively; P = 0.42) and percentage needing touch up ablation between the 2 groups (26% vs. 20%, respectively; P = 0.45). At a mean follow‐up of 454 ± 195 days, 282 of 324 (87%) patients were free from any atrial tachyarrhythmias (ATs) after a single procedure. Twenty out of 27 (74%) Group A patients and 262 of 297 (88%) Group B patients were free from ATs (15‐month Kaplan–Meier event free rate estimates, 77% and 89%, respectively; P = 0.02). A multivariate analysis identified the presence of an LCPV and the left atrial diameter as reliable predictors of recurrent ATs. Conclusions The long‐term clinical outcomes of ablation of AF with the CB was worse in patients with an LCPV than in those without. The presence of an LCPV and the LA size seemed to be reliable predictors of a worse outcome.