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Cool enough? Lessons learned from cryoballoon‐guided catheter ablation for atrial fibrillation in young adults
Author(s) -
Bergau Leonard,
El Hamriti Mustapha,
Rubarth Kerstin,
Dagher Lilas,
Molatta Stephan,
Braun Martin,
Khalaph Moneeb,
Imnadze Guram,
Nölker Georg,
Nowak Claus P.,
Fox Henrik,
Sommer Philipp,
Sohns Christian
Publication year - 2020
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.14717
Subject(s) - medicine , atrial fibrillation , atrial tachycardia , pulmonary vein , hazard ratio , catheter ablation , ablation , cardiology , observational study , premature atrial contraction , atrial flutter , tachycardia , radiofrequency ablation , surgery , confidence interval
Cryoballoon (CB)‐guided ablation of atrial fibrillation (AF) is established in symptomatic AF patients. This study sought to determine the safety and efficacy of CB pulmonary vein isolation (PVI) in young adults. Methods and Results A total of 93 consecutive patients aged <45 years referred to our center for AF ablation were included in this observational study. All patients received CB‐guided PVI according to a standardized institutional protocol. Follow‐up was performed in our outpatient clinic using 72‐h Holter monitoring and periodic telephone interview. Recurrence was defined as any AF/atrial tachycardia (AT) episode >30 s following a 3‐month blanking period. A propensity matched control group consisting of patients older than 45 years were used for further evaluation. Mean age was 35 ± 7 years, 22% suffered from persistent AF, 85% were male. Mean follow‐up was 2.6 ± 2 years. At the end of the observational period, 83% of patients were free of any AF/AT episodes. There was an excellent overall 12‐month success rate of 92%. In comparison to a matched group the overall recurrence rate was noticeably lower in the young group (15% vs. 27%). Increasing age was associated with a hazard ratio of 1.16 for recurrence. In a multivariate analysis model, left atrial diameter remained as significant predictor of AF/AT recurrence. The complication rate was low, no permanent phrenic nerve palsy was observed. Conclusion CB‐guided PVI in young adults is safe and effective with favorable long‐term results. It may be considered as first‐line therapy in this relatively healthy population.