What is the real recurrence rate after cryoballoon-based pulmonary vein isolation? Lessons from rhythm follow-up based on implanted cardiac devices with continuous atrial monitoring

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Christian-Hendrik HeegerAndreas Metzner

Abstract

Second-generation cryoballoon (CB2)-based pulmonary vein isolation (PVI) has demonstrated encouraging clinical results for the treatment of paroxysmal atrial fibrillation (AF) and persistent AF. However, rhythm follow-up after PVI is mainly based on Holter electrocardiography of limited duration. The purpose of this study was to assess the real AF burden following CB2-based PVI in patients with implanted cardiac devices. A total of 670 consecutive patients underwent CB2-based PVI at 3 electrophysiology centers. In 66 patients (9.9%), an implantable cardiac device with continuous monitor function was independently implanted before the procedure (device group). This patient cohort was compared to propensity score-matched patients without cardiac devices (n = 66; control group). A total of 254 of 258 PVs (98.4%0 in the device group were successfully isolated using only CB2. Postprocedural device interrogation found no device or lead malfunction related to the procedure. Periprocedural complications were registered in 7 of 66 patients (11%) in the device group and in 6 of 66 patients (9%) in the control group (P = .770). Phrenic nerve palsy occurred in 6 of 66 patients (9%) in the device group) and in 2 of 66 patients (3%) in the c...Continue Reading

Citations

Mar 10, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Rajdip DulaiRick A Veasey
Oct 21, 2020·Journal of Cardiovascular Electrophysiology·Graham LohrmannRod Passman
Dec 22, 2020·Journal of Cardiovascular Electrophysiology·Graham Lohrmann, Rod Passman
Nov 21, 2020·JACC. Clinical Electrophysiology·Tilman MaurerKarl-Heinz Kuck
Apr 4, 2020·International Journal of Cardiology·Christian-Hendrik HeegerAndreas Metzner
Nov 7, 2020·Pacing and Clinical Electrophysiology : PACE·Marcus Wieczorek, Reinhard Hoeltgen

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