Turk Kardiyol Dern Ars. 2019; 47(6): 440-448 | DOI: 10.5543/tkda.2019.88469
Effect of cryoballoon ablation parameters on recurrence in patients with paroxysmal atrial fibrillation
Abdullah Orhan Demirtaş1
, Yahya Kemal İçen1
, Yurdaer Dönmez1
, Hasan Koca1
, Onur Kaypakli2
, Durmuş Yıldıray Şahin1
, Mevlüt Koç11
Department of Cardiology, University of Health Sciences Adana State Training and Research Hospital, Adana, Turkey2
Department of Cardiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
OBJECTIVE The aim of this research was to investigate the relationship between atrial fibrillation (AF) recurrence and second generation cryoballoon ablation (CBA) procedural parameters in patients with non-valvular paroxysmal AF (PAF).
METHODS A total of 131 patients with a PAF diagnosis who underwent second-generation CBA (59 male; mean age: 55.2±10.6 years) were enrolled. Recurrence was defined as the detection of AF on a 12-lead electrocardiography (ECG) recording, or an attack lasting at least 30 seconds observed on Holter ECG records. CBA procedural data and echocardiographic findings were recorded and compared.
RESULTS After 1 year of follow-up, AF recurrence was detected in 27 patients. Patients with recurrence were older and had higher rates of hypertension and diabetes (p<0.05 for both). Left atrial diameter, left atrial volume (LaV), left atrial volume index, and the averaged warming angle (calculated by combining lowest temperature point and balloon temperature at 20°C point) were significantly higher in the recurrence group. Balloon warming time was significantly longer in the non-recurrence group (p<0.001). In binary logistic regression analysis, the averaged warming angle (odds ratio [OR]: 1.559, 95% confidence interval [CI]: 1.3421.811; p<0.001) and LaV (OR: 1.063, 95% CI: 1.0281.100; p<0.001) were found to be independent parameters for predicting recurrence. The cutoff value of the warming angle obtained with ROC curve analysis was 50° for the prediction of recurrence (sensitivity: 94.3%, specificity: 88.5%, area under the curve: 0.909; p<0.001). The cutoff value of LaV obtained by ROC curve analysis was 53.5 for prediction of recurrence (sensitivity: 77.8%, specificity: 74.5%; p<0.001).
CONCLUSION Measurement of balloon warming angle during CBA and increased LaV may predict the AF recurrence.
Atrial fibrillation, cryoballoon ablation; recurrence.
How to cite this article
Abdullah Orhan Demirtaş, Yahya Kemal İçen, Yurdaer Dönmez, Hasan Koca, Onur Kaypakli, Durmuş Yıldıray Şahin, Mevlüt Koç. Effect of cryoballoon ablation parameters on recurrence in patients with paroxysmal atrial fibrillation. Turk Kardiyol Dern Ars. 2019; 47(6): 440-448
Corresponding Author: Abdullah Orhan Demirtaş, Türkiye