The importance of extrapulmonary vein triggers and atypical atrial flutter in atrial fibrillation recurrence after cryoablation: Insights from repeat ablation procedures

Ting Yung Chang, Li Wei Lo, Abigail Louise D. Te, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Fa Po Chung, Tze Fan Chao, Jo Nan Liao, Ta Chuan Tuan, Chin Yu Lin, Jennifer Jeanne Vicera, Ting Chun Huang, Minh Quang Hoang, Shinya Yamada, Shih Ann Chen

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Introduction: It has not been previously investigated whether the recurrence mechanism after cryoballoon ablation (CBA) of paroxysmal atrial fibrillation (AF) is similar to that of radiofrequency catheter ablation (RFCA). We aimed to evaluate the differences of recurrence characteristics between RFCA and CBA after the index procedure. Methods: A total of 210 patients were enrolled in the study, and 69 patients underwent pulmonary vein (PV) isolation using a 28-mm second-generation CBA. The control group comprising 140 patients underwent PV isolation using an open-irrigated radiofrequency ablation catheter. A total of 69 patients in the CBA group and 69 patients in the RFCA group were investigated after propensity score matching. Recurrence patterns of AF were studied in the repeated procedure. Results: During the index procedure, there was no difference in PV or non-PV triggers between the two groups. Nineteen (27.5%) patients in the CBA group and 19 (27.5%) patients in the RFCA group had recurrence after a follow-up of 11.3 ± 7 months. The Kaplan-Meier curve did not reveal significant difference in recurrence (log-rank, P = 0.364) between the two groups. In the second procedure, the CBA group had more non-PV triggers (63.6%, P = 0.009) and left atrial (LA) flutters (54.5%, P = 0.027) compared with the RFCA group (12.5% and 12.5%, respectively). The PV reconnection rates were similar between both groups. Conclusions: There was no difference in AF recurrence after catheter ablation between CBA and RFCA, but significant increases of non-PV triggers and LA flutter during the second procedure suggest the importance of the atrial substrate in maintaining AF during the second procedure after previous CBA.

Original languageEnglish
Pages (from-to)16-24
Number of pages9
JournalJournal of Cardiovascular Electrophysiology
Volume30
Issue number1
DOIs
Publication statusPublished - 2019 Jan

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'The importance of extrapulmonary vein triggers and atypical atrial flutter in atrial fibrillation recurrence after cryoablation: Insights from repeat ablation procedures'. Together they form a unique fingerprint.

Cite this