Safety and Efficacy of Cryoablation for Atrial Fibrillation in Young Patients: A Multicenter Experience in the 1STOP Project

Overview

Journal Clin Cardiol

Specialty Cardiology & Vascular Diseases

Date 2022 Nov 30

PMID 36448243

Authors

Emanuele Bertaglia

Saverio Iacopino

Roberto Verlato

Giuseppe Arena

Paolo Pieragnoli

Claudio Tondo

Giulio Molon

Massimiliano Manfrin

Giovanni B Perego

Giovanni Rovaris

Francesco Rivezzi

Massimo Mantica

Umberto Startari

Luigi Sciarra

Affiliations

Soon will be listed here.

Abstract

Background: Atrial fibrillation (AF) is an uncommon arrhythmia in young adults without structural heart disease, and cryoballoon pulmonary vein isolation (CB-PVI) is an important therapeutic strategy for rhythm control in patients with drug-refractory AF. The aim of this analysis was to evaluate efficacy and safety of CB-PVI in a large cohort of young patients in comparison with middle-aged adults in a real-world setting.

Methods: From 2012 to 2020, a total of 3033 patients with AF underwent CB-PVI and were followed prospectively in the framework of the 1STOP Clinical Service project, involving 34 Italian centers. Out of 3033 total 1STOP project subjects, a subgroup of 1318 patients were defined which included a YOUNG group (age ≤ 45 years; n = 368) and a MIDDLE-AGED group (age 60-65 years; n = 950).

Results: The acute success rate of PVI did not differ between the two cohorts (99.9 ± 1.3% vs. 99.8 ± 3.2%, p = 0.415). There was no difference in procedural characteristics, and periprocedural complication rates were similar among the two cohort (1.9% vs. 2.3%, p = 0.646). The 12-month freedom from AF recurrence was 88.9% (95% confidence interval [CI]: 84.7-92.0) in the YOUNG cohort and 85.6% (95% CI: 82.9-88.0) in the MIDDLE-AGED group. At 36-month follow-up, freedom from AF recurrence was 72.4% (65.5%-78.2%) and 71.8% (67.7%-75.6%), respectively with no significant difference among groups (p = 0.550).

Conclusion: CB-PVI had similar efficacy and safety in YOUNG and MIDDLE-AGED patients. Younger age did not affect acute procedural results, complication rate, or AF recurrence after a single procedure.

Citing Articles

Safety and efficacy of cryoablation for atrial fibrillation in young patients: A multicenter experience in the 1STOP project.

Bertaglia E, Iacopino S, Verlato R, Arena G, Pieragnoli P, Tondo C Clin Cardiol. 2022; 46(2):142-150.

PMID: 36448243 PMC: 9933101. DOI: 10.1002/clc.23951.

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