TY - JOUR
T1 - Vasovagal responses during cryoballoon pulmonary vein isolation in paroxysmal atrial fibrillation predict favorable mid-term outcomes
AU - Te, Abigail Louise D.
AU - Lo, Li Wei
AU - Lin, Yenn Jiang
AU - Chang, Shih Lin
AU - Hu, Yu Feng
AU - Chung, Fa Po
AU - Tuan, Ta Chuan
AU - Chao, Tze Fan
AU - Liao, Jo Nan
AU - Chang, Yao Ting
AU - Lin, Chin Yu
AU - Yamada, Shinya
AU - Chang, Ting Yung
AU - Salim, Simon
AU - Hoang, Minh Quang
AU - Huang, Ting Chun
AU - Chen, Shih Ann
N1 - Funding Information:
The present work was supported by the Taipei Veterans General Hospital ( V103C-042 , V103C-126 , V103E7-002 , VGHUST103-G1-3-1 , V104C-131 , V104E7-003 , V105C-60 , V106C-114 , V105C-60 , V106C-114 , VGHUS107-G1-8-1 , V107C-099 ), Ministry of Science and Technology ( NSC 102-2325-B-010-005 , MOST 103-2314-B-075-062-MY3 , MOST 1062314-B-010-054 ), and Research Foundation of Cardiovascular Medicine ( RFCM 100-02-011 , 101-01-001 , 104-01-009-01 ).
Funding Information:
The present work was supported by the Taipei Veterans General Hospital (V103C-042, V103C-126, V103E7-002, VGHUST103-G1-3-1, V104C-131, V104E7-003, V105C-60, V106C-114, V105C-60, V106C-114, VGHUS107-G1-8-1, V107C-099), Ministry of Science and Technology (NSC 102-2325-B-010-005, MOST 103-2314-B-075-062-MY3, MOST 1062314-B-010-054), and Research Foundation of Cardiovascular Medicine (RFCM 100-02-011, 101-01-001, 104-01-009-01).
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background: Vasovagal responses (VR) encountered during radiofrequency pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF) suggest ablation of the atrial tissue subjacent to the ganglionic plexi (GP) and confer durability of PVI. Objective: We hypothesized that VR during cryoballoon PVI (CB-PVI) in PAF can predict mid-term AF recurrence. Methods: We enrolled 39 patients who underwent PVI using 2nd generation cryoballoon for PAF from November 2014 to July 2016. We evaluated the long term outcomes for those who had VR during index procedure. Results: A total of 39 patients (76% male, mean age 57 ± 9 years) underwent CB-PVI for PAF and 66.67% (26/39) had VR. VR was frequently observed in the LSPV (100%), followed by RSPV (64%), LIPV (60%), and less frequently, RIPV (28%). Overall, the mean difference in the HR and SBP, and the relative differences in the HR and SBP were observed during CB-PVI in the LSPV (mean difference in HR, p < 0.001; mean difference in SBP, p < 0.001; relative difference in HR, p < 0.001); relative difference in SBP, p < 0.001). After PVI, 22/26 (84.62%) and 5/13 (38.46%) of patients in the VR and NVR group, respectively, maintained SR at 14 ± 6 months follow-up. The Kaplan-Meier analysis showed statistical difference in favor of patients with VR during CB-PVI (log rank p < 0.01) with a better mid-term outcome. Conclusion: In a small cohort of patients, VR during CB-PVI in PAF is a surrogate marker for ablation of atrial tissue subjacent to the GP and predicts a favorable mid-term outcome for AF recurrence.
AB - Background: Vasovagal responses (VR) encountered during radiofrequency pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF) suggest ablation of the atrial tissue subjacent to the ganglionic plexi (GP) and confer durability of PVI. Objective: We hypothesized that VR during cryoballoon PVI (CB-PVI) in PAF can predict mid-term AF recurrence. Methods: We enrolled 39 patients who underwent PVI using 2nd generation cryoballoon for PAF from November 2014 to July 2016. We evaluated the long term outcomes for those who had VR during index procedure. Results: A total of 39 patients (76% male, mean age 57 ± 9 years) underwent CB-PVI for PAF and 66.67% (26/39) had VR. VR was frequently observed in the LSPV (100%), followed by RSPV (64%), LIPV (60%), and less frequently, RIPV (28%). Overall, the mean difference in the HR and SBP, and the relative differences in the HR and SBP were observed during CB-PVI in the LSPV (mean difference in HR, p < 0.001; mean difference in SBP, p < 0.001; relative difference in HR, p < 0.001); relative difference in SBP, p < 0.001). After PVI, 22/26 (84.62%) and 5/13 (38.46%) of patients in the VR and NVR group, respectively, maintained SR at 14 ± 6 months follow-up. The Kaplan-Meier analysis showed statistical difference in favor of patients with VR during CB-PVI (log rank p < 0.01) with a better mid-term outcome. Conclusion: In a small cohort of patients, VR during CB-PVI in PAF is a surrogate marker for ablation of atrial tissue subjacent to the GP and predicts a favorable mid-term outcome for AF recurrence.
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U2 - 10.1016/j.ijcard.2018.01.111
DO - 10.1016/j.ijcard.2018.01.111
M3 - Article
C2 - 29467097
AN - SCOPUS:85042169443
VL - 258
SP - 115
EP - 120
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -