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Clinical results of atrial fibrillation patients treated with cryoballoon ablation: A single center experience

Year 2014, Volume: 5 Issue: 4, 599 - 603, 01.12.2014
https://doi.org/10.5799/ahinjs.01.2014.04.0466

Abstract

Objectives: Atrial fibrillation (AF), the most common arrhythmia in clinical practice, is a major cause of stroke. Atrial fibrillation increases morbidity and mortality. Nowadays cryoablation therapy is being performed efficiently and safely worldwide. In this paper the clinical outcomes of the patients whom were treated with cryoablation were discussed. Methods: Between June 2012 and March 2014, patients with paroxysmal AF who were treated with cryoablation were included in the study. The medical records of the patients were retrospectively reviewed. Patients were called to receive information about the symptom recurrence. Results: Twelve patients were included in the study. Half of the patients were female. The mean age was 48 ± 15 years. Acute procedural success rate of cryoablation was 100%. In one patient transient right phrenic nerve injury occurred which was returned to normal after discontinuation of cryoablation therapy. One patient developed AF episode for 10 minutes in the 4th month of follow-up period. Conclusion: In patients with paroxysmal atrial fibrillation cryoablation effectively decrease symptoms consistent with the literature. J Clin Exp Invest 2014; 5 (4): 599-603

References

  • Go AS, Hylek EM, Phillips KA, et al. Prevalence of diag- nosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-2375.
  • European Heart Rhythm Association; European Asso- ciation for Cardio-Thoracic Surgery, Camm AJ, Kirch- hof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiol- ogy (ESC). Eur Heart J 2010;31:2369-2429.
  • Ball J, Carrington MJ, McMurray JJ, Stewart S. Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. Int J Cardiol 2013;167:1807-1824.
  • Warfarin versus aspirin for prevention of thromboem- bolism in atrial fibrillation: Stroke Prevention in Atrial Fibrillation II Study. Lancet 1994;343:687-691.
  • Rockson SG, Albers GW. Comparing the guidelines: anticoagulation therapy to optimize stroke preven- tion in patients with atrial fibrillation. J Am Coll Cardiol 2004;43: 929-935.
  • Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originat- ing in the pulmonary veins. NEJM 1998;339:659-666.
  • Calkins H, Reynolds MR, Spector P, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofre- quency ablation: two systematic literature reviews and meta-analyses. Circulation Arrhythmia Electrophysiol 2009;2:349-361.
  • Wilber DJ, Pappone C, Neuzil P, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atri- al fibrillation: a randomized controlled trial. JAMA 2010;303:333-340.
  • Wazni OM, Marrouche NF, Martin DO, et al. Radiofre- quency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a random- ized trial. JAMA 2005;293:2634-2640.
  • Tanner H, Makowski K, Roten L, et al. Catheter abla- tion of atrial fibrillation as first-line therapy-a single- centre experience. Europace 2011;13:646-653.
  • Wazni O, Wilkoff B, Saliba W. Catheter ablation for atrial fibrillation. NEJM 2011;365:2296-2304.
  • Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/ EHRA/ECAS Expert Consensus Statement on Cath- eter and Surgical Ablation of Atrial Fibrillation: recom- mendations for patient selection, procedural tech- niques, patient management and follow-up, defini- tions, endpoints, and research trial design. Europace 2012;14:528-606.
  • Cappato R, Calkins H, Chen SA, et al. Updated world- wide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circula- tion Arrhythmia Electrophysiol 2010;3:32-38.
  • Dagres N, Hindricks G, Kottkamp H, et al. Compli- cations of atrial fibrillation ablation in a high-volume center in 1,000 procedures: still cause for concern? J Cardiovasc Electrophysiol 2009;20:1014-1019.
  • Neumann T, Vogt J, Schumacher B, et al. Circum- ferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study. J Am Coll Cardiol 2008;52:273-278.
  • Van Belle Y, Janse P, Rivero-Ayerza M J, et al. Pulmo- nary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-termoutcome. Eur Heart J 2007;28:2231-2237.
  • Tse HF, Reek S, Timmermans C, et al. Pulmonary vein isolation using transvenous catheter cryoablation for treatment of atrial fibrillation without risk of pulmonary vein stenosis. J Am Coll Cardiol 2003;42:752-758.
  • Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European So- ciety of Cardiology (ESC). Europace 2010;12:1360- 1420.
  • Aytemir K, Oto A, Canpolat U, et al. Immediate and medium-term outcomes of cryoballoon-based pulmo- nary vein isolation in patients with paroxysmal and persistent atrial fibrillation: single-centre experience. J Interv Card Electrophysiol 2013;38:187-195.
  • Andrade JG, Khairy P, Guerra PG, et al. Efficacy and safety of cryoballoon ablation for atrial fibrillation: a systematic review of published studies. Heart Rhythm 2011;8;1444-1451.
  • Vogt J, Heintze J, Gutleben KJ, et al. Long-term out- comes after cryoballoon pulmonary vein isolation: re- sults from a prospective study in 605 patients. J Am Coll Cardiol 2013;61:1707-1712.
  • Akoum N, Daccarett M, McGann C, et al. Atrial fibro- sis helps select the appropriate patient and strategy in catheter ablation of atrial fibrillation: a DE-MRI guided approach. J Cardiovasc Electrophysiol 2011;22:16- 22.
  • Abecasis J, Dourado R, Ferreira A, et al. Left atrial volume calculated by multidetector computed tomog- raphy may predict successful pulmonary vein isola- tion in catheter ablation of atrial fibrillation. Europace 2009;11:1289-1294.
  • Arya A, Hindricks G, Sommer P, et al. Long-term re- sults and the predictors of outcome of catheter abla- tion of atrial fibrillation using steerable sheath catheter navigation after single procedure in 674 patients. Eu- ropace 2010;12:173-180.
  • Balk E M, Garlitski AC, Alsheikh-Ali AA, et al. Predic- tors of atrial fibrillation recurrence after radiofrequency catheter ablation: a systematic review. J Cardiovasc Electrophysiol 2010;21:1208-1216.
  • Berruezo A, Tamborero D, Mont L, et al. Pre-proce- dural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation. Eur Heart J 2007;28:836-841.
  • McCready JW, Smedley T, Lambiase PD, et al. Pre- dictors of recurrence following radiofrequency abla- tion for persistent atrial fibrillation. Europace 2011;13: 355-361.
  • Bertaglia E, Zoppo F, Tondo C, et al. Early compli- cations of pulmonary vein catheter ablation for atrial fibrillation: a multicenter prospective registry on pro- cedural safety. Heart Rhythm 2007;4:1265-1271.
  • Bitter T, Nolker G, Vogt J, et al. Predictors of recur- rence in patients undergoing cryoballoon ablation for treatment of atrial fibrillation: the independent role of sleep-disordered breathing. J Cardiovasc Electro- physiol 2012;23:18-25.
  • Dascenzo F, Corleto A, Biondi-Zoccai, et al. Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: a meta-analy- sis. Int J Cardiol 2013;167:1984-1989.
  • Andrade JG, Dubuc M, Rivard L, et al. Efficacy and safety of atrial fibrillation ablation with phased radio- frequency energy and multielectrode catheters. Heart Rhythm 2012;9:289- 296.
  • Hoffmann E, Dorwarth U, Kuck KH, et al. Design and baseline patient characteristics of the prospective, observational, multicenter and multinational cohort study comparing radiofrequency with cryoablation for pulmonary vein isolation in patients with atrial fi- brillation- The Freeze Cohort Study. Int J Clin Med 2014;5:1161-1172.
  • Packer DL, Kowal RC, Wheelan KR, et al. for the STOP AF Cryoablation Investigators. Cryoballoon Ab- lation of Pulmonary Veins for Paroxysmal Atrial Fibril- lation. J Am Coll Cardiol 2013;61:1713-1723.

Atriyal fibrilasyonlu hastaların kriyobalon ablasyon yöntemi ile tedavisi sonuçları: Tek merkez deneyimi

Year 2014, Volume: 5 Issue: 4, 599 - 603, 01.12.2014
https://doi.org/10.5799/ahinjs.01.2014.04.0466

Abstract

Amaç: Atriyal fibrilasyon (AF) klinik pratikte en sık karşılaşılan aritmi olmakla beraber inmenin en önemli nedenidir. Atriyal fibrilasyon morbiditeyi ve mortaliteyi artırmaktadır. Kriyoablasyon tedavisi günümüzde bütün dünyada yaygın bir şekilde etkin ve güvenli bir şekilde yapılmaktadır. Bu yazıda kriyoablasyon tedavisi yaptığımız hastaların klinik sonuçları tartışıldı. Yöntemler: Haziran 2012 ve Mart 2014 tarihleri arasında kriyoablasyon tedavisi uygulanmış paroksismal AF\'li hastalar çalışmaya dahil edildi. Hasta dosyalarındaki veriler retrospektif olarak incelendi. Telefonla ulaşılan hastalar semptomlar açısından sorgulandı. Bulgular: Çalışmada 12 hasta değerlendirildi. Hastaların %50\'si kadındı. Yaş ortalaması 48 ± 15 yıl idi. Kriyoablasyon akut işlem başarısı %100 idi. İşlem sırasında komplikasyon olarak sadece bir hastada geçici sağ taraf frenik sinir hasarı gelişti ve işleme son verildi. Bir hastamızda 4. ay takibinde 10 dakika süren AF atağı gelişti. Sonuç: Bu çalışma ile literatür ile uyumlu olarak paroksismal atriyal fibrilasyonlu hastalarda kriyoablasyon tedavisi ile güvenli ve etkin bir şekilde semptomlardaki iyileşme gösterilmiştir

References

  • Go AS, Hylek EM, Phillips KA, et al. Prevalence of diag- nosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-2375.
  • European Heart Rhythm Association; European Asso- ciation for Cardio-Thoracic Surgery, Camm AJ, Kirch- hof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiol- ogy (ESC). Eur Heart J 2010;31:2369-2429.
  • Ball J, Carrington MJ, McMurray JJ, Stewart S. Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. Int J Cardiol 2013;167:1807-1824.
  • Warfarin versus aspirin for prevention of thromboem- bolism in atrial fibrillation: Stroke Prevention in Atrial Fibrillation II Study. Lancet 1994;343:687-691.
  • Rockson SG, Albers GW. Comparing the guidelines: anticoagulation therapy to optimize stroke preven- tion in patients with atrial fibrillation. J Am Coll Cardiol 2004;43: 929-935.
  • Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originat- ing in the pulmonary veins. NEJM 1998;339:659-666.
  • Calkins H, Reynolds MR, Spector P, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofre- quency ablation: two systematic literature reviews and meta-analyses. Circulation Arrhythmia Electrophysiol 2009;2:349-361.
  • Wilber DJ, Pappone C, Neuzil P, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atri- al fibrillation: a randomized controlled trial. JAMA 2010;303:333-340.
  • Wazni OM, Marrouche NF, Martin DO, et al. Radiofre- quency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a random- ized trial. JAMA 2005;293:2634-2640.
  • Tanner H, Makowski K, Roten L, et al. Catheter abla- tion of atrial fibrillation as first-line therapy-a single- centre experience. Europace 2011;13:646-653.
  • Wazni O, Wilkoff B, Saliba W. Catheter ablation for atrial fibrillation. NEJM 2011;365:2296-2304.
  • Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/ EHRA/ECAS Expert Consensus Statement on Cath- eter and Surgical Ablation of Atrial Fibrillation: recom- mendations for patient selection, procedural tech- niques, patient management and follow-up, defini- tions, endpoints, and research trial design. Europace 2012;14:528-606.
  • Cappato R, Calkins H, Chen SA, et al. Updated world- wide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circula- tion Arrhythmia Electrophysiol 2010;3:32-38.
  • Dagres N, Hindricks G, Kottkamp H, et al. Compli- cations of atrial fibrillation ablation in a high-volume center in 1,000 procedures: still cause for concern? J Cardiovasc Electrophysiol 2009;20:1014-1019.
  • Neumann T, Vogt J, Schumacher B, et al. Circum- ferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study. J Am Coll Cardiol 2008;52:273-278.
  • Van Belle Y, Janse P, Rivero-Ayerza M J, et al. Pulmo- nary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-termoutcome. Eur Heart J 2007;28:2231-2237.
  • Tse HF, Reek S, Timmermans C, et al. Pulmonary vein isolation using transvenous catheter cryoablation for treatment of atrial fibrillation without risk of pulmonary vein stenosis. J Am Coll Cardiol 2003;42:752-758.
  • Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European So- ciety of Cardiology (ESC). Europace 2010;12:1360- 1420.
  • Aytemir K, Oto A, Canpolat U, et al. Immediate and medium-term outcomes of cryoballoon-based pulmo- nary vein isolation in patients with paroxysmal and persistent atrial fibrillation: single-centre experience. J Interv Card Electrophysiol 2013;38:187-195.
  • Andrade JG, Khairy P, Guerra PG, et al. Efficacy and safety of cryoballoon ablation for atrial fibrillation: a systematic review of published studies. Heart Rhythm 2011;8;1444-1451.
  • Vogt J, Heintze J, Gutleben KJ, et al. Long-term out- comes after cryoballoon pulmonary vein isolation: re- sults from a prospective study in 605 patients. J Am Coll Cardiol 2013;61:1707-1712.
  • Akoum N, Daccarett M, McGann C, et al. Atrial fibro- sis helps select the appropriate patient and strategy in catheter ablation of atrial fibrillation: a DE-MRI guided approach. J Cardiovasc Electrophysiol 2011;22:16- 22.
  • Abecasis J, Dourado R, Ferreira A, et al. Left atrial volume calculated by multidetector computed tomog- raphy may predict successful pulmonary vein isola- tion in catheter ablation of atrial fibrillation. Europace 2009;11:1289-1294.
  • Arya A, Hindricks G, Sommer P, et al. Long-term re- sults and the predictors of outcome of catheter abla- tion of atrial fibrillation using steerable sheath catheter navigation after single procedure in 674 patients. Eu- ropace 2010;12:173-180.
  • Balk E M, Garlitski AC, Alsheikh-Ali AA, et al. Predic- tors of atrial fibrillation recurrence after radiofrequency catheter ablation: a systematic review. J Cardiovasc Electrophysiol 2010;21:1208-1216.
  • Berruezo A, Tamborero D, Mont L, et al. Pre-proce- dural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation. Eur Heart J 2007;28:836-841.
  • McCready JW, Smedley T, Lambiase PD, et al. Pre- dictors of recurrence following radiofrequency abla- tion for persistent atrial fibrillation. Europace 2011;13: 355-361.
  • Bertaglia E, Zoppo F, Tondo C, et al. Early compli- cations of pulmonary vein catheter ablation for atrial fibrillation: a multicenter prospective registry on pro- cedural safety. Heart Rhythm 2007;4:1265-1271.
  • Bitter T, Nolker G, Vogt J, et al. Predictors of recur- rence in patients undergoing cryoballoon ablation for treatment of atrial fibrillation: the independent role of sleep-disordered breathing. J Cardiovasc Electro- physiol 2012;23:18-25.
  • Dascenzo F, Corleto A, Biondi-Zoccai, et al. Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: a meta-analy- sis. Int J Cardiol 2013;167:1984-1989.
  • Andrade JG, Dubuc M, Rivard L, et al. Efficacy and safety of atrial fibrillation ablation with phased radio- frequency energy and multielectrode catheters. Heart Rhythm 2012;9:289- 296.
  • Hoffmann E, Dorwarth U, Kuck KH, et al. Design and baseline patient characteristics of the prospective, observational, multicenter and multinational cohort study comparing radiofrequency with cryoablation for pulmonary vein isolation in patients with atrial fi- brillation- The Freeze Cohort Study. Int J Clin Med 2014;5:1161-1172.
  • Packer DL, Kowal RC, Wheelan KR, et al. for the STOP AF Cryoablation Investigators. Cryoballoon Ab- lation of Pulmonary Veins for Paroxysmal Atrial Fibril- lation. J Am Coll Cardiol 2013;61:1713-1723.
There are 33 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Mesut Aydın This is me

Nihat Polat This is me

Murat Yüksel This is me

Necdet Özaydoğdu This is me

Yahya İslamoğlu This is me

Publication Date December 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 4

Cite

APA Aydın, M., Polat, N., Yüksel, M., Özaydoğdu, N., et al. (2014). Atriyal fibrilasyonlu hastaların kriyobalon ablasyon yöntemi ile tedavisi sonuçları: Tek merkez deneyimi. Journal of Clinical and Experimental Investigations, 5(4), 599-603. https://doi.org/10.5799/ahinjs.01.2014.04.0466
AMA Aydın M, Polat N, Yüksel M, Özaydoğdu N, İslamoğlu Y. Atriyal fibrilasyonlu hastaların kriyobalon ablasyon yöntemi ile tedavisi sonuçları: Tek merkez deneyimi. J Clin Exp Invest. December 2014;5(4):599-603. doi:10.5799/ahinjs.01.2014.04.0466
Chicago Aydın, Mesut, Nihat Polat, Murat Yüksel, Necdet Özaydoğdu, and Yahya İslamoğlu. “Atriyal Fibrilasyonlu hastaların Kriyobalon Ablasyon yöntemi Ile Tedavisi sonuçları: Tek Merkez Deneyimi”. Journal of Clinical and Experimental Investigations 5, no. 4 (December 2014): 599-603. https://doi.org/10.5799/ahinjs.01.2014.04.0466.
EndNote Aydın M, Polat N, Yüksel M, Özaydoğdu N, İslamoğlu Y (December 1, 2014) Atriyal fibrilasyonlu hastaların kriyobalon ablasyon yöntemi ile tedavisi sonuçları: Tek merkez deneyimi. Journal of Clinical and Experimental Investigations 5 4 599–603.
IEEE M. Aydın, N. Polat, M. Yüksel, N. Özaydoğdu, and Y. İslamoğlu, “Atriyal fibrilasyonlu hastaların kriyobalon ablasyon yöntemi ile tedavisi sonuçları: Tek merkez deneyimi”, J Clin Exp Invest, vol. 5, no. 4, pp. 599–603, 2014, doi: 10.5799/ahinjs.01.2014.04.0466.
ISNAD Aydın, Mesut et al. “Atriyal Fibrilasyonlu hastaların Kriyobalon Ablasyon yöntemi Ile Tedavisi sonuçları: Tek Merkez Deneyimi”. Journal of Clinical and Experimental Investigations 5/4 (December 2014), 599-603. https://doi.org/10.5799/ahinjs.01.2014.04.0466.
JAMA Aydın M, Polat N, Yüksel M, Özaydoğdu N, İslamoğlu Y. Atriyal fibrilasyonlu hastaların kriyobalon ablasyon yöntemi ile tedavisi sonuçları: Tek merkez deneyimi. J Clin Exp Invest. 2014;5:599–603.
MLA Aydın, Mesut et al. “Atriyal Fibrilasyonlu hastaların Kriyobalon Ablasyon yöntemi Ile Tedavisi sonuçları: Tek Merkez Deneyimi”. Journal of Clinical and Experimental Investigations, vol. 5, no. 4, 2014, pp. 599-03, doi:10.5799/ahinjs.01.2014.04.0466.
Vancouver Aydın M, Polat N, Yüksel M, Özaydoğdu N, İslamoğlu Y. Atriyal fibrilasyonlu hastaların kriyobalon ablasyon yöntemi ile tedavisi sonuçları: Tek merkez deneyimi. J Clin Exp Invest. 2014;5(4):599-603.