Influence of balloon temperature and time to pulmonary vein isolation on acute pulmonary vein reconnection and clinical outcomes after cryoballoon ablation of atrial fibrillation

• Published in: Journal of arrhythmia 2018-10, Vol.34 (5), p.511-519
• Main Authors: Watanabe, Ryuta, Okumura, Yasuo, Nagashima, Koichi, Iso, Kazuki, Takahashi, Keiko, Arai, Masaru, Wakamatsu, Yuji, Kurokawa, Sayaka, Ohkubo, Kimie, Nakai, Toshiko, Yoda, Shunichi, Watanabe, Ichiro, Hirayama, Atsushi, Sonoda, Kazumasa, Tosaka, Toshimasa
• Format: Article
• Language: English
• Subjects: Ablation (Surgery); acute pulmonary vein reconnection; Adenosine triphosphate; Atrial fibrillation; Cardiac arrhythmia; Catheters; Clinical outcomes; cryoballoon ablation; Muscle proteins; Original; Patient outcomes; Patients; Prognosis; Temperature
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.12108

Background Limited data exist on indicators of durable pulmonary vein isolation (PVI) undergoing cryoballoon ablation (CBA) for atrial fibrillation (AF). We investigated whether balloon temperature and time to PVI can be used to predict early PV reconduction (EPVR), including residual PV conduction and adenosine triphosphate‐induced dormant conduction and the relation between touch‐up ablation of EPVR sites and mid‐term recurrence of AF. Methods We obtained procedural and outcome data from the records of 130 consecutive patients who underwent CBA and followed up for 13.4 months. Results EPVR was identified in 86 (17%) PVs of 61 (47%) patients. Balloon temperatures during 30 seconds (−27 ± 5.7°C vs −31 ± 5.5°C), 60 seconds (−36 ± 5.6°C vs −41 ± 5.4°C), and at the nadir point (−41 ± 7.4°C vs −49 ± 7.0°C) were significantly higher, and the time to PVI was longer (90 ± 50 seconds vs 52 ± 29 seconds) in PVs with EPVR than in those without (P