Details

Autor(en) / Beteiligte

• Álvarez-Ortega, Carlos Antonio
• Solórzano Guillén, César Rainer
• Barrera Cordero, Alberto
• Toquero Ramos, Jorge Enrique
• Martínez-Alday, Jesús Daniel
• Grande Morales, Carlos Eugenio
• Rodríguez González, Aníbal
• García Alberola, Arcadio
• Pérez Álvarez, Luisa
• Ferrero de Loma Osorio, Ángel
• Hernández Afonso, Julio Salvador
• Cózar León, Rocío
• Cano Pérez, Óscar
• Trucco, Emilce
• Peinado Peinado, Rafael

Titel

Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice?

Ist Teil von

• Cardiology journal, 2024-04, Vol.31 (2), p.193-204

Ort / Verlag

Poland: Wydawnictwo Via Medica

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Ablation of atrial fibrillation (AF), both cryoablation ablation (CBA) and radiofrequency catheter ablation (RFCA), have demonstrated to be safe and effective. About 1 in 3 patients may face a redo due to recurrence and the best technique is unknown. The aim of this study is to assess the efficacy of CBA as a repeat procedure in patients with prior CBA or RFCA. A nation-wide CBA registry (RECABA) was analyzed and patients were compared who had previously undergone CBA (Prior-CB) or RFCA (Prior-RF). The primary endpoint was AF recurrence at 12 months after a 3-month blanking period. A survival analysis was performed, univariate and multivariate Cox models were also built. Seventy-four patients were included. Thirty-three (44.6%) were in the Prior-CB group and 41 (55.4%) in the Prior-RF. There were more reconnected pulmonary veins in the Prior-RF than in Prior-CB group (40.4% vs.16.5%, p = 0.0001). The 12-month Kaplan-Meier estimate of freedom from AF recurrence after the blanking period was 61.0% (95% confidence interval [CI] 41.4-75.8%) in the Prior-CB, and 89.2% (95% CI 73.6-95.9%) in the Prior-RF group (p = 0.002). Multivariate Cox regression pointed Prior-CB as the sole independent predictor of AF recurrence, with an adjusted HR of 2.67 (95% CI 1.05-6.79). Repeat CBA shows higher rates of AF recurrences compared to CBA after a previous RFCA despite presenting less reconnected veins at the procedure. These data suggest that patients with AF recurrence after CBA may benefit from other ablation techniques after a recurrence. RECABA is registered at clinicaltrials.gov with the Unique Identifier NCT02785991.