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Outcome in patients with left common pulmonary vein after cryoablation with second‐generation cryoballoon
Author(s) -
Beiert Thomas,
Lodde Pia C.,
Linneborn Lutz P.T.,
Werner Jessica,
Prinz Lisa,
Stöckigt Florian,
Linhart Markus,
Lickfett Lars,
Nickenig Georg,
Schrickel Jan W.,
Andrié René P.
Publication year - 2018
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13247
Subject(s) - medicine , cryoablation , pulmonary vein , atrial fibrillation , hazard ratio , cardiology , proportional hazards model , surgery , ablation , vein , cohort , confidence interval
Background Pulmonary vein isolation (PVI) has become a widely accepted therapy in patients suffering from symptomatic atrial fibrillation (AF). Hypothesis AF‐free survival differs in patients with left common pulmonary vein (LCPV) after PVI with second‐generation cryoballoon. Methods We included patients scheduled for first PVI for paroxysmal or persistent AF. Symptomatic and/or documented arrhythmia episodes (>30 seconds) were defined as AF recurrence, excluding a 3‐month blanking period. Results We observed a LCPV in 37 of 270 consecutive patients (13.7%). Analyses were performed in a 1:1 propensity score matched cohort of 68 patients. During a median follow‐up of 77.0 weeks, 37 patients (54.4%) had recurrent AF. The prevalence of LCPV was numerically higher in patients with AF recurrence (62.2% vs 35.5%, P = 0.051) and Kaplan‐Meier analysis showed lower AF‐free survival in patients with existence of a LCPV (P = 0.028). At 1‐year follow‐up, 70.6% of patients without versus 55.1% of patients with LCPV were free of AF. Multivariate Cox regression analysis revealed presence of a LCPV (hazard ratio [HR]: 2.996), chronic heart failure (HR: 3.423), and mitral regurgitation > I° (HR: 2.571) as predictors of AF recurrence. Conclusion Patients with LCPV had significantly reduced AF‐free survival after ablation with the second‐generation cryoballoon, despite similar acutely successful PVIs.