Balloon Cryoablation for Paroxysmal Atrial Fibrillation. Initial Experience

José L. González, Néstor Galizio, Guillermo Carnero, Federico Robles, Mauricio Mysuta

Abstract


Background: Pulmonary vein isolation is the cornerstone for the treatment of patients with recurrent and symptomatic paroxysmalatrial fibrillation (PAF). Balloon cryoablation (BCA) is an option to radiofrequency with shorter procedural and fluoroscopy times.Objectives: The aim of this study was to describe the immediate outcomes and the initial experience in the first BCA procedures forPAF in our hospital.Methods: Between November 2013 and February 2015, 23 patients underwent BCA for PAF. A computed tomography angiographywith reconstruction of the left atrium and pulmonary veins was performed before the procedure.Results: Mean age was 53±11 years, 19 patients were men, left atrial dimension was 40±7 mm and LVEF was 58%±8%. AverageCHA2DS2VASc score was 0.6. The average procedural time was 169±47 minutes, with a fluoroscopy time of 39±17 minutes. Isolationof the pulmonary veins was achieved in 89/91 pulmonary veins (97.8%), and 2 patients required additional radiofrequencycatheter ablation. One patient (4.34%) presented transient paralysis of the diaphragm with spontaneous recovery after 30 minutes.No further complications were observed.After a median follow-up of 9.2 months, 21 patients (91.3%) remained with sinus rhythm.Conclusions: In this initial experience, BCA for PAF proved to be a safe and effective technique in selected patients. A high acute successrate was achieved for pulmonary vein isolation. During follow-up, the recurrence rate was low. The real impact of the procedurewill be known when long-term outcomes become available.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar