Abstract 16923: Low Incidence of Peri Procedural Complications After Cryoballoon Ablation of Atrial Fibrillation Based on Atrial Fibrillation Type (Paroxysmal vs Persistent) and Center Expertise (High Volume vs Low Volume)
Introduction: Pulmonary veins ablation is an approved therapy in symptomatic, recurrent atrial fibrillation (AF).
Hypothesis: We evaluated whether the incidence of peri-procedural complications after cryoballoon ablation (CBA) of AF could be influenced by AF type, Persistent (PER) vs. Paroxysmal (PAF), or centers experience.
Methods: From April 2012, 1152 patients (74% male, 59±10 years, 22% PER) underwent pulmonary veins CBA. Data were prospectively collected in the framework of the 1STOP ClinicalService® project. Data were analyzed according to type of AF and learning curve groups. Centers expertise groups were defined according to quartiles of the distribution of the number of performed procedures: 6.3%, 19.3%, 16.9% and 57.5% of patients were respectively followed in each group from 1st to 4th quartile of expertise. Major complications were defined according to 2010 Cappato survey.
Results: PER patients had a significantly worse cardiac condition (NYHA≥2: PER 22.8% vs PAF 11.2% p<0.001, cardiac insufficiency: PER 8.3% vs PAF 2.3% p<0.001, and mitral valve disease: PER 8.2% vs PAF 4.2% p=0.011) and significantly larger left atrium dimensions (mean left atrial volume: PER 77±28 cm3 vs PAF 61±25 cm3, p<0.001). Procedure and fluoroscopy time were comparable in the 2 groups. In 50 (4.3%) patients a peri-procedural complication occurred, major in 17 (1.5%) patients (4 pts cardiac tamponade, 3 pts permanent diaphragmatic paralysis, 1 pts pneumothorax/hemothorax, 2 pts femoral pseudo-aneurysm, 2 pts transient ischemic attack, 5 pts peri-cardiac effusion). No patients experienced an atrio-esophageal fistula, stroke, death, or other major peri-interventional complications. Incidence of peri-procedural complications were not different between PER and PAF and there was a non significant decreasing trend, from 6.8% to 3.5%, as the expertise increased. The most frequent minor acute complication was transient diaphragmatic paralysis, the incidence decreased from 4.1% to 1.4% as the expertise increased (p=NS).
Conclusions: CBA technology is a safe ablation treatment for both persistent and paroxysmal AF; peri-procedural complications are low in all the analyzed sub-groups, showing a decreasing trend in function of center expertise.
Author Disclosures: L. Padeletti: None. M. Lunati: None. G. Arena: None. A. Curnis: None. M. Moltrasio: None. R. Verlato: None. S. Porcellini: None. L. Sciarra: None. G. Senatore: None. L. Leoni: None. M. Maines: None. S. Iacopino: None. G. Allocca: None. W. Rahue: None. M. Landolina: None.
- © 2016 by American Heart Association, Inc.