Safety and efficacy of cryoablation for atrial fibrillation in young patients: A multicenter experience in the 1STOP project.
atrial fibrillation
catheter ablation
cryoballoon ablation
young patients
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
revised:
11
10
2022
received:
01
06
2022
accepted:
30
10
2022
pubmed:
1
12
2022
medline:
18
2
2023
entrez:
30
11
2022
Statut:
ppublish
Résumé
Atrial fibrillation (AF) is an uncommon arrhythmia in young adults without structural heart disease, and cryoballoon pulmonary vein isolation (CB-PVI) is an important therapeutic strategy for rhythm control in patients with drug-refractory AF. The aim of this analysis was to evaluate efficacy and safety of CB-PVI in a large cohort of young patients in comparison with middle-aged adults in a real-world setting. From 2012 to 2020, a total of 3033 patients with AF underwent CB-PVI and were followed prospectively in the framework of the 1STOP Clinical Service project, involving 34 Italian centers. Out of 3033 total 1STOP project subjects, a subgroup of 1318 patients were defined which included a YOUNG group (age ≤ 45 years; n = 368) and a MIDDLE-AGED group (age 60-65 years; n = 950). The acute success rate of PVI did not differ between the two cohorts (99.9 ± 1.3% vs. 99.8 ± 3.2%, p = 0.415). There was no difference in procedural characteristics, and periprocedural complication rates were similar among the two cohort (1.9% vs. 2.3%, p = 0.646). The 12-month freedom from AF recurrence was 88.9% (95% confidence interval [CI]: 84.7-92.0) in the YOUNG cohort and 85.6% (95% CI: 82.9-88.0) in the MIDDLE-AGED group. At 36-month follow-up, freedom from AF recurrence was 72.4% (65.5%-78.2%) and 71.8% (67.7%-75.6%), respectively with no significant difference among groups (p = 0.550). CB-PVI had similar efficacy and safety in YOUNG and MIDDLE-AGED patients. Younger age did not affect acute procedural results, complication rate, or AF recurrence after a single procedure.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial fibrillation (AF) is an uncommon arrhythmia in young adults without structural heart disease, and cryoballoon pulmonary vein isolation (CB-PVI) is an important therapeutic strategy for rhythm control in patients with drug-refractory AF. The aim of this analysis was to evaluate efficacy and safety of CB-PVI in a large cohort of young patients in comparison with middle-aged adults in a real-world setting.
METHODS
METHODS
From 2012 to 2020, a total of 3033 patients with AF underwent CB-PVI and were followed prospectively in the framework of the 1STOP Clinical Service project, involving 34 Italian centers. Out of 3033 total 1STOP project subjects, a subgroup of 1318 patients were defined which included a YOUNG group (age ≤ 45 years; n = 368) and a MIDDLE-AGED group (age 60-65 years; n = 950).
RESULTS
RESULTS
The acute success rate of PVI did not differ between the two cohorts (99.9 ± 1.3% vs. 99.8 ± 3.2%, p = 0.415). There was no difference in procedural characteristics, and periprocedural complication rates were similar among the two cohort (1.9% vs. 2.3%, p = 0.646). The 12-month freedom from AF recurrence was 88.9% (95% confidence interval [CI]: 84.7-92.0) in the YOUNG cohort and 85.6% (95% CI: 82.9-88.0) in the MIDDLE-AGED group. At 36-month follow-up, freedom from AF recurrence was 72.4% (65.5%-78.2%) and 71.8% (67.7%-75.6%), respectively with no significant difference among groups (p = 0.550).
CONCLUSION
CONCLUSIONS
CB-PVI had similar efficacy and safety in YOUNG and MIDDLE-AGED patients. Younger age did not affect acute procedural results, complication rate, or AF recurrence after a single procedure.
Identifiants
pubmed: 36448243
doi: 10.1002/clc.23951
pmc: PMC9933101
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
142-150Informations de copyright
© 2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.
Références
Europace. 2015 Apr;17(4):559-65
pubmed: 25582875
Europace. 2018 Nov 1;20(11):1750-1757
pubmed: 29518195
N Engl J Med. 2015 May 7;372(19):1812-22
pubmed: 25946280
Eur Heart J. 2016 Oct 07;37(38):2858-2865
pubmed: 27381589
Cardiol Res Pract. 2013;2013:976976
pubmed: 23401843
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
Clin Res Cardiol. 2013 Jun;102(6):459-68
pubmed: 23503755
J Cardiovasc Electrophysiol. 2015 Aug;26(8):832-839
pubmed: 25917655
Cardiol Res Pract. 2021 Dec 28;2021:9996047
pubmed: 34992884
Pacing Clin Electrophysiol. 2017 Jan;40(1):46-56
pubmed: 27862043
Heart Lung Circ. 2020 Jul;29(7):1078-1086
pubmed: 31594723
Am J Cardiol. 2022 Mar 1;166:53-57
pubmed: 34973688
Clin Cardiol. 2023 Feb;46(2):142-150
pubmed: 36448243
Circ Arrhythm Electrophysiol. 2010 Oct;3(5):452-7
pubmed: 20858861
Circ Arrhythm Electrophysiol. 2010 Feb;3(1):32-8
pubmed: 19995881
Eur Heart J. 2006 Apr;27(8):949-53
pubmed: 16527828
J Cardiovasc Electrophysiol. 2021 Apr;32(4):949-957
pubmed: 33644913
Europace. 2018 Feb 1;20(2):295-300
pubmed: 28122804
Europace. 2018 Jan 1;20(1):58-64
pubmed: 28017937
Am J Cardiol. 2022 Mar 1;166:45-52
pubmed: 34961604
Europace. 2010 Feb;12(2):181-7
pubmed: 19887458