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. (1st December 2018)

• Record Type: Journal Article
• Authors: Landolina, Maurizio; Arena, Giuseppe; Iacopino, Saverio; Verlato, Roberto; Pieragnoli, Paolo; Curnis, Antonio; Lunati, Maurizio; Rauhe, Werner; Senatore, Gaetano; Sciarra, Luigi; Molon, Giulio; Agricola, Pietro Maria G.; Padeletti, Luigi; Tondo, Claudio
• Is Part Of: International journal of cardiology. Volume 272(2018)
• Page Start: 130
• Page End: 136
• Publication Date: 2018-12-01
• Subjects: Atrial fibrillation -- Ablation of atrial fibrillation -- Cryoablation -- Outcomes -- AF recurrence; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.07.051
• Languages: English
• ISSNs: 0167-5273

Abstract

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) Highlights: The acute PVI success rate is high even in less experienced centers (96.3%). As the centers' experience increased, the acute success rate increased till 99.0% The acute complications' incidence was low: decreased as the experience increased As the centers' experience increased, procedural duration decreased. The freedom from AF recurrence was not influenced by the level of experience.