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Turk Kardiyol Dern Ars. 2019 Sep;47(6):440-448. doi: 10.5543/tkda.2019.88469.

Effect of cryoballoon ablation parameters on recurrence in patients with paroxysmal atrial fibrillation.

Author information

1
Department of Cardiology, University of Health Sciences Adana State Training and Research Hospital, Adana, Turkey.
2
Department of Cardiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey.

Abstract

OBJECTIVE:

The aim of this research was to investigate the relationship between atrial fibrillation (AF) recurrence and second generation cryoballoon ablation (CBA) procedural parameters in patients with non-valvular paroxysmal AF (PAF).

METHODS:

A total of 131 patients with a PAF diagnosis who underwent second-generation CBA (59 male; mean age: 55.2±10.6 years) were enrolled. Recurrence was defined as the detection of AF on a 12-lead electrocardiography (ECG) recording, or an attack lasting at least 30 seconds observed on Holter ECG records. CBA procedural data and echocardiographic findings were recorded and compared.

RESULTS:

After 1 year of follow-up, AF recurrence was detected in 27 patients. Patients with recurrence were older and had higher rates of hypertension and diabetes (p<0.05 for both). Left atrial diameter, left atrial volume (LaV), left atrial volume index, and the averaged warming angle (calculated by combining lowest temperature point and balloon temperature at 20°C point) were significantly higher in the recurrence group. Balloon warming time was significantly longer in the non-recurrence group (p<0.001). In binary logistic regression analysis, the averaged warming angle (odds ratio [OR]: 1.559, 95% confidence interval [CI]: 1.342-1.811; p<0.001) and LaV (OR: 1.063, 95% CI: 1.028-1.100; p<0.001) were found to be independent parameters for predicting recurrence. The cutoff value of the warming angle obtained with ROC curve analysis was 50° for the prediction of recurrence (sensitivity: 94.3%, specificity: 88.5%, area under the curve: 0.909; p<0.001). The cutoff value of LaV obtained by ROC curve analysis was 53.5 for prediction of recurrence (sensitivity: 77.8%, specificity: 74.5%; p<0.001).

CONCLUSION:

Measurement of balloon warming angle during CBA and increased LaV may predict the AF recurrence.

PMID:
31483314
DOI:
10.5543/tkda.2019.88469
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