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Int J Cardiol. 2018 Dec 1;272:130-136. doi: 10.1016/j.ijcard.2018.07.051. Epub 2018 Jul 18.

Center experience does not influence long-term outcome and peri-procedural complications after cryoballoon ablation of paroxysmal atrial fibrillation: Data on 860 patients from the real-world multicenter observational project.

Author information

1
ASST Ospedale Maggiore, Crema, Italy. Electronic address: maurizio.landolina02@gmail.com.
2
Nuovo Ospedale delle Apuane, Massa, Italy.
3
Maria Cecilia Hospital, GVM Care & Research Group, Cotignola, Italy.
4
ULSS 15 Padovana, in ULSS 6 Euganea, Camposampiero, Italy.
5
Careggi Hospital, Florence, Italy.
6
Azienza Ospedaliera Spedali Civili, Brescia, Italy.
7
ASST GOM Niguarda, Italy.
8
Ospedale Centrale di Bolzano, Divisione di Cardiologia, Bolzano, Italy.
9
General Hospital Ciriè, Torino, Italy.
10
Policlinico Casilino, Rome, Italy.
11
Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
12
ASST Ospedale Maggiore, Crema, Italy; Casa di Cura Privata Piacenza, Italy.
13
University of Florence, Italy; IRCCS Multimedica, Milano, Italy.
14
Heart Rhythm Center at Monzino Cardiac Center, IRCC Dept. of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

Abstract

BACKGROUND:

The aim of this research was to evaluate whether the procedural data, the incidence of complications, and the long-term freedom from atrial fibrillation (AF) recurrences are influenced by center experience in a paroxysmal AF (PAF) population performing a first-time pulmonary vein isolation (PVI) by cryoballoon ablation (CBA).

METHODS:

A total of 860 patients underwent PVI by CBA. Center experience groups were predefined according to the quartiles of the distribution regarding the amount of performed procedures: 3.1%, 10.6%, 22.7% and 63.6% of patients were respectively followed in each group from 1st (less experienced) to 4th (more experienced) quartile of experience.

RESULTS:

In the entire population, median procedure and fluoroscopy time were 105 and 25 min, respectively. The median procedure time significantly decreased from 130 to 90 min (P < 0.001) as the center's experience increased. In 47 (5.5%) patients, a peri-procedural complication occurred. As the experience of centers increased, the acute intraprocedural PVI success rate increased (from 94.3% to 98.9%, P = 0.007), whereas there was a tendency towards a decreased incidence of peri-procedure complications (from 7.4% to 4.6%, P = 0.998). The mean 1-year freedom from AF recurrence probability was 78.3%, and the 18-month mean was 68.9% with no difference among the groups with different levels of experience.

CONCLUSION:

CBA is a safe and effective treatment for patients with PAF. Peri-procedural complications and procedural times were low in all the analyzed sub-groups, showing a decreasing trend in function of center expertise. The long-term freedom from AF recurrence was not influenced by the level of experience. (clinicaltrials.gov: NCT01007474).

KEYWORDS:

AF recurrence; Ablation of atrial fibrillation; Atrial fibrillation; Cryoablation; Outcomes

PMID:
30045822
DOI:
10.1016/j.ijcard.2018.07.051
[Indexed for MEDLINE]

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