Cardiovascular Implantable Electronic Devices -> Monitoring & Outcomes: -> Monitoring & Follow-up D-PO05 - Poster Session V (ID 39) Poster

D-PO05-086 - Defining The Blanking Period After Cryoballoon Pulmonary Vein Isolation (ID 540)

Abstract

Background: Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation procedures. A three-month blanking period (BP) is commonly used in clinical trials and practice. However, the actual duration of the BP following cryoballoon (CB) PVI remains undefined.
Objective: To objectively define the BP duration in pts undergoing CB PVI.
Methods: We enrolled consecutive pts with paroxysmal (PAF) or persistent AF (PeAF) who had CB PVI and an implantable loop recorder (ILR, Reveal LINQ, Medtronic). We prospectively followed pts and determined time of last AF episode in 1st 90 days post-ablation BP. This was then correlated with likelihood of having a first episode of AF recurrence after the 3-month BP.
Results: There were 184 pts (66 ± 10 years; 114 [62%] male; 99 [54%] PAF; CHA2DS2-VASc 2.7 ± 1.7; 114 [62%] on AAD at ablation and 53 (29%) on AAD 3 months later). We defined 4 distinct groups post ablation based on whether or not they had AF in the BP: (1) no AF days 0-90 (n=84 [46%]), (2) AF days 0-30 (n=39 [21%]), (3) AF days 31-60 (n=14 [8%]), and (4) AF days 61-90 (n=46 [25%]). Following the end of the 3-month BP, 122 pts had a recurrence of AF at a mean of 244 ± 194 days. Compared to pts with no AF in the BP, those with recurrent AF after 30 days post-ablation had a significantly greater likelihood of recurrent AF during long-term follow-up (p=0.001, Figure).
Conclusion: Our data show that the ~1/3 of patients in whom AF occurs more than 30 days post PVI are at significantly higher risk of recurrent AF. When AF occurs 2-3 months post ablation, long-term AF recurrence is virtually assured. We, therefore, suggest that the BP be limited to a month post CB PVI.
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