TY - JOUR T1 - Medium- and long-term outcome after a single second-generation cryoballoon ablation in patients with paroxysmal and persistent atrial fibrillation JO - Revista Portuguesa de Cardiologia (English edition) T2 - AU - Elvira Ruiz,Ginés AU - Peñafiel Verdú,Pablo AU - Martínez Sánchez,Juan AU - Sánchez Muñoz,Juan José AU - García Almagro,Francisco José AU - Muñoz Esparza,Carmen AU - García Alberola,Arcadi SN - 21742049 M3 - 10.1016/j.repce.2019.05.026 DO - 10.1016/j.repce.2019.05.026 UR - https://revportcardiol.org/en-medium-long-term-outcome-after-single-articulo-S2174204920300805 AB - Introduction and objectivesTo report medium- and long-term results following a single second-generation cryoballoon (CB2)-based ablation procedure in patients with paroxysmal (PAF) and persistent (PeAF) atrial fibrillation. MethodsA retrospective study was performed of consecutive patients undergoing a first CB2-based ablation procedure in a tertiary center. Cryoenergy was applied for 3 min if a time to effect <60 s was documented or 4 min otherwise, with a bonus application in cases of late isolation or suboptimal temperature. Follow-up was obtained from the regional health electronic records system and by telephone or personal interviews. Recurrence was defined as any atrial arrhythmia >30 s beyond a three-month blanking period. The clinical impact of recurrences was classified using a severity score. ResultsA total of 172 patients (134 PAF and 38 PeAF) were included, of whom 25 (14.5%) had structural heart disease and 120 (69.7%) had a normal or mildly dilated left atrium. Acute success was achieved in 167 (97.1%). After a median follow-up of 27 (14-41) months, 100 patients (58.1%) remained free of atrial arrhythmias (64.2% for PAF and 36.8% for PeAF, p=0.006). Left atrial size (p=0.05) and clinical presentation as PeAF (p=0.006) were predictors of recurrence. Of patients with recurrences, 11.1% did not require further therapies and an additional 16.7% had good control with antiarrhythmic drugs. ConclusionsA single CB2 procedure resulted in 58.1% of patients remaining free of atrial arrhythmias at 27-month follow-up. Conservative management was useful in 27.8% of patients with recurrences. ER -