TY - JOUR
T1 - Shorter RSPV cryoapplications result in less phrenic nerve injury and similar 1-year freedom from atrial fibrillation
AU - Molenaar, Marleen M. D.
AU - Hesselink, Tim
AU - ter Bekke, Rachel M. A.
AU - Scholten, Marcoen F.
AU - Manusama, Randy
AU - Pison, Laurent
AU - Brusse-Keizer, Marjolein
AU - Kraaier, Karin
AU - ten Haken, Bernard
AU - Grandjean, Jan G.
AU - Timmermans, Carl C.
AU - van Opstal, Jurren M.
N1 - Wiley deal
PY - 2020/10
Y1 - 2020/10
N2 - Background: In the 123-study, we prospectively assessed, in a randomized fashion, the minimal cryoballoon application time necessary to achieve pulmonary vein (PV) isolation (PVI) in patients with paroxysmal atrial fibrillation (AF) with the aim to reduce complications by shortening the application duration. The first results of this study demonstrated that shortened cryoballoon applications (<2 minutes) resulted in less phrenic nerve injury (PNI) without compromising acute isolation efficacy for the right PVs. We now report the 1-year follow-up results regarding safety and efficacy of shorter cryoballoon applications. Methods: A total of 222 patients with AF were randomized to two applications of 1 min “short,” 2 min “medium,” or 3 min “long” duration, 74 per group. Recurrence of AF and PV reconduction at 1-year follow-up were assessed. Results: The overall 1-year freedom from AF was 79% and did not differ significantly between the short, medium, and long application groups (77%, 74%, and 85% for short, medium, and long application groups, respectively; P = 0.07). In 30 patients, a redo PVI procedure was performed. For all four PVs, there was no significant difference in reconduction between the three groups. Reconduction was most common in the left superior PV (57%). The right superior PV (RSPV) showed significantly less reconduction (17%) compared to the other PVs. Conclusions: Shortening cryoballoon applications of the RSPV to <2 minutes results in less PNI, while acute success and 1-year freedom from AF are not compromised. Therefore, shorter cryoballoon applications (especially) in the RSPV could be used to reduce PNI.
AB - Background: In the 123-study, we prospectively assessed, in a randomized fashion, the minimal cryoballoon application time necessary to achieve pulmonary vein (PV) isolation (PVI) in patients with paroxysmal atrial fibrillation (AF) with the aim to reduce complications by shortening the application duration. The first results of this study demonstrated that shortened cryoballoon applications (<2 minutes) resulted in less phrenic nerve injury (PNI) without compromising acute isolation efficacy for the right PVs. We now report the 1-year follow-up results regarding safety and efficacy of shorter cryoballoon applications. Methods: A total of 222 patients with AF were randomized to two applications of 1 min “short,” 2 min “medium,” or 3 min “long” duration, 74 per group. Recurrence of AF and PV reconduction at 1-year follow-up were assessed. Results: The overall 1-year freedom from AF was 79% and did not differ significantly between the short, medium, and long application groups (77%, 74%, and 85% for short, medium, and long application groups, respectively; P = 0.07). In 30 patients, a redo PVI procedure was performed. For all four PVs, there was no significant difference in reconduction between the three groups. Reconduction was most common in the left superior PV (57%). The right superior PV (RSPV) showed significantly less reconduction (17%) compared to the other PVs. Conclusions: Shortening cryoballoon applications of the RSPV to <2 minutes results in less PNI, while acute success and 1-year freedom from AF are not compromised. Therefore, shorter cryoballoon applications (especially) in the RSPV could be used to reduce PNI.
KW - UT-Hybrid-D
KW - cryoballoon
KW - phrenic nerve injury
KW - pulmonary vein isolation
KW - safety
KW - atrial fibrillation
UR - http://www.scopus.com/inward/record.url?scp=85090999747&partnerID=8YFLogxK
U2 - 10.1111/pace.14062
DO - 10.1111/pace.14062
M3 - Article
SN - 0147-8389
VL - 43
SP - 1173
EP - 1179
JO - Pacing and clinical electrophysiology
JF - Pacing and clinical electrophysiology
IS - 10
ER -