Journal of Arrhythmia (Oct 2021)

Repeat procedures for recurrent persistent atrial fibrillation: A propensity‐matched score comparison between left atrial linear ablation with radiofrequency and posterior wall isolation with the cryoballoon

  • Antonio Bisignani,
  • Luigi Pannone,
  • Gezim Bala,
  • Shuichiro Kazawa,
  • Paul Calburean,
  • Ingrid Overeinder,
  • Cinzia Monaco,
  • Felicia Lipartiti,
  • Vincenzo Miraglia,
  • Sergio Rizzi,
  • Maysam Al Housari,
  • Joerelle Mojica,
  • Antanas Strazdas,
  • Thiago Guimarães Osório,
  • Juan Sieira,
  • Saverio Iacopino,
  • Alexandre Almorad,
  • Erwin Ströker,
  • Antonio Sorgente,
  • Pedro Brugada,
  • Carlo deAsmundis,
  • Gian‐Battista Chierchia

DOI
https://doi.org/10.1002/joa3.12614
Journal volume & issue
Vol. 37, no. 5
pp. 1287 – 1294

Abstract

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Abstract Aims To evaluate the clinical outcome in patients undergoing repeat procedures for recurrent persistent atrial fibrillation following an index cryoballoon (CB‐A) pulmonary vein isolation ablation on a mid‐term follow‐up of 12 months. Methods In this propensity score‐matched comparison, 50 patients undergoing left atrial posterior wall isolation (LAPWI) with the CB‐A were matched to 50 patients treated with additional linear ablation using radiofrequency catheter ablation (RFCA). Results Meantime to repeat the procedure was 9.74 ± 4.36 months. At 12 months follow‐up freedom from atrial tachyarrhythmias (ATas) was achieved in 82% of patients in the LAPWI group and in 62% of patients in the linear ablation group (P = .03). Regression analysis demonstrated that relapses during the blanking period and LA dimensions were independent predictors of ATas recurrences following the repeat procedure. Conclusion LAPWI using CB‐A is associated with a significantly higher freedom from atrial arrhythmias when compared with the RFCA mediated left atrial linear lesions on a mid‐term follow‐up of 12 months in patients with persAF undergoing a redo procedure.

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