Catheter Ablation -> SVT/AVNRT/WPW/AT: -> Quality Measures & Complications D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-157 - Long Term Follow up After Cryoballoon Pulmonary Vein Isolation In Atrial Fibrillation Using Different Freeze Protocols: The Fafa “Ice 4 Vs. 3” Propensity Matched Comparison (ID 1507)

 S. Chen: Nothing relevant to disclose.


Background: The second-generation cryoballoon (CB2) represents an effective ablation technology for pulmonary vein isolation (PVI). Time-to-isolation (TTI) guided ablation has been shown efficient for PVI. To better balance the procedure success and risk different ablation protocols have been proposed.
Objective: To compare the clinical efficacy and safety of CB2 PVI using the TTI guided 4min vs.3 min freeze protocol in long term follow-up.
Methods: This was a propensity-matched comparison study based on institutional registry database. The TTI guided PVI concept was introduced to clinical routine since May 2013. All patients with symptomatic AF who underwent CB2 PVI were enrolled. In patients the target freeze time was initially set to 4min thereafter consecutively followed by 3min. Patients were matched according to propensity score in a logistic regression model.
Results: From database registered 1280 patients, a total 214 (107 matched pairs) symptomatic AF (paroxysmal AF: 61%, persistent AF: 39%) patients (mean age 67.7±11.2 years) were analyzed from the database from May 2013 to December 2017. The baseline characteristics were comparable between the 4min and 3min groups. Procedural time and fluoroscopic time were significantly longer in the 4min vs. 3min group (67.2±21.8 vs. 55.9±16.9 min, p<0.0001, 13.5±7.7 vs. 9.7±4.1 min, p=0.011). During a mean follow-up of 2 years, the 4min group was associated with significantly lower risk of AF/AT recurrence compared with 3min group (66.4% vs. 56.1%, Log-Rank Test P: 0.009). No peri-procedural death, stroke, MI and tamponade were observed. There were no differences regarding procedural adverse events (puncture site bleeding, transient/persistent PNP, esophageal temperature <15℃) between groups.
Conclusion: Target freeze duration of 4min using CB2 is associated with significantly lower risk of AF/AT recurrence in long term follow-up.