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One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation

(2008) EUROPACE. 10(11). p.1271-1276
Author
Organization
Abstract
Aims: Pulmonary vein isolation (PVI) with cryoenergy delivered through a balloon is a new approach in the treatment of atrial fibrillation (AF), but long-term follow-up is lacking. The aim of this study was to provide insight in the success rate and the incidence of recurrences. Methods and results: Patients with symptomatic AF despite anti-arrhythmic drugs (AADs) were treated with cryoballoon PVI. Daily transtelephonic ECG monitoring, 24 h Holter-ECG, and an arrhythmia-focused questionnaire were used to document AF. One hundred and forty-one patients completed a follow-up of 457 +/- 252 days. Before ablation, Holter-ECG showed AF in 45%, including 16% continuous AF throughout the recording. Event recording revealed a median AF burden of 26%. The questionnaire showed a median of weekly AF complaints lasting for hours. All but one patient had successful PVI with a single procedure. After ablation, AF (defined as lasting for more than 30 s) was seen in 11% of Holter-ECGs, with 1% continuous AF. The event recording showed an AF burden of 9%. The median patient reported no more AF-related symptoms. Recurrence during the first 3 months was predictive for later recurrence. A second procedure was performed in 24 patients. The freedom of AF was 59% without AADs after 1,2 procedures. Four right phrenic nerve paralyses occurred, all resolving within 6 months. No PV stenoses were observed. Conclusion: Pulmonary vein isolation with a cryothermal balloon is an effective treatment for paroxysmal AF, resulting in a clinical success rate comparable to studies involving radiofrequency ablation. Temporary right phrenic nerve paralysis is the most important complication.
Keywords
Follow-up, Cryoballoon, Cryoablation, Atrial fibrillation, Ablation, CATHETER ABLATION, BALLOON CATHETER, EFFICACY, SAFETY, CRYOABLATION, CONDUCTION, ULTRASOUND, RESUMPTION, JUNCTION, SYSTEM

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Chicago
Van Belle, Yves, Petter Janse, Dominic Theuns, Tamas Szili-Torok, and Luc Jordaens. 2008. “One Year Follow-up After Cryoballoon Isolation of the Pulmonary Veins in Patients with Paroxysmal Atrial Fibrillation.” Europace 10 (11): 1271–1276.
APA
Van Belle, Yves, Janse, P., Theuns, D., Szili-Torok, T., & Jordaens, L. (2008). One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation. EUROPACE, 10(11), 1271–1276.
Vancouver
1.
Van Belle Y, Janse P, Theuns D, Szili-Torok T, Jordaens L. One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation. EUROPACE. 2008;10(11):1271–6.
MLA
Van Belle, Yves et al. “One Year Follow-up After Cryoballoon Isolation of the Pulmonary Veins in Patients with Paroxysmal Atrial Fibrillation.” EUROPACE 10.11 (2008): 1271–1276. Print.
@article{8151369,
  abstract     = {Aims: Pulmonary vein isolation (PVI) with cryoenergy delivered through a balloon is a new approach in the treatment of atrial fibrillation (AF), but long-term follow-up is lacking. The aim of this study was to provide insight in the success rate and the incidence of recurrences. 
Methods and results: Patients with symptomatic AF despite anti-arrhythmic drugs (AADs) were treated with cryoballoon PVI. Daily transtelephonic ECG monitoring, 24 h Holter-ECG, and an arrhythmia-focused questionnaire were used to document AF. One hundred and forty-one patients completed a follow-up of 457 +/- 252 days. Before ablation, Holter-ECG showed AF in 45%, including 16% continuous AF throughout the recording. Event recording revealed a median AF burden of 26%. The questionnaire showed a median of weekly AF complaints lasting for hours. All but one patient had successful PVI with a single procedure. After ablation, AF (defined as lasting for more than 30 s) was seen in 11% of Holter-ECGs, with 1% continuous AF. The event recording showed an AF burden of 9%. The median patient reported no more AF-related symptoms. Recurrence during the first 3 months was predictive for later recurrence. A second procedure was performed in 24 patients. The freedom of AF was 59% without AADs after 1,2 procedures. Four right phrenic nerve paralyses occurred, all resolving within 6 months. No PV stenoses were observed. 
Conclusion: Pulmonary vein isolation with a cryothermal balloon is an effective treatment for paroxysmal AF, resulting in a clinical success rate comparable to studies involving radiofrequency ablation. Temporary right phrenic nerve paralysis is the most important complication.},
  author       = {Van Belle, Yves and Janse, Petter and Theuns, Dominic and Szili-Torok, Tamas and Jordaens, Luc},
  issn         = {1099-5129},
  journal      = {EUROPACE},
  keywords     = {Follow-up,Cryoballoon,Cryoablation,Atrial fibrillation,Ablation,CATHETER ABLATION,BALLOON CATHETER,EFFICACY,SAFETY,CRYOABLATION,CONDUCTION,ULTRASOUND,RESUMPTION,JUNCTION,SYSTEM},
  language     = {eng},
  number       = {11},
  pages        = {1271--1276},
  title        = {One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation},
  url          = {http://dx.doi.org/10.1093/europace/eun218},
  volume       = {10},
  year         = {2008},
}

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