Center experience does not influence long-term outcome and peri-procedural complications after cryoballoon ablation of paroxysmal atrial fibrillation: Data on 860 patients from the real-world multicenter observational project

被引:17
作者
Landolina, Maurizio [1 ]
Arena, Giuseppe [2 ]
Iacopino, Saverio [3 ]
Verlato, Roberto [4 ]
Pieragnoli, Paolo [5 ]
Curnis, Antonio [6 ]
Lunati, Maurizio [7 ]
Rauhe, Werner [8 ]
Senatore, Gaetano [9 ]
Sciarra, Luigi [10 ]
Molon, Giulio [11 ]
Agricola, Pietro Maria G. [1 ,12 ]
Padeletti, Luigi [13 ,14 ]
Tondo, Claudio [15 ]
机构
[1] ASST Osped Maggiore, Crema, Italy
[2] Nuovo Osped Apuane, Massa, Italy
[3] Maria Cecilia Hosp, GVM Care & Res Grp, Cotignola, Italy
[4] ULSS 6 Euganea, ULSS Padovana 15, Camposampiero, Italy
[5] Careggi Hosp, Florence, Italy
[6] Azienza Osped Spedali Civil, Brescia, Italy
[7] ASST GOM Niguarda, Milan, Italy
[8] Osped Cent Bolzano, Div Cardiol, Bolzano, Italy
[9] Gen Hosp Cirie, Turin, Italy
[10] Policlin Casilino, Rome, Italy
[11] Sacro Cuore Don Calabria Hosp, Verona, Italy
[12] Casa Cura Privata Piacenza, Piacenza, Italy
[13] Univ Florence, Florence, Italy
[14] IRCCS Multimed, Milan, Italy
[15] Univ Milan, Heart Rhythm Ctr Monzino Cardiac Ctr, IRCC Dept Clin Sci & Community Hlth, Milan, Italy
关键词
Atrial fibrillation; Ablation of atrial fibrillation; Cryoablation; Outcomes; AF recurrence; PULMONARY VEIN ISOLATION; TIME-TO-ISOLATION; CATHETER ABLATION; RADIOFREQUENCY ABLATION; 2ND-GENERATION CRYOBALLOON; LEARNING-CURVE; FOLLOW-UP; MANAGEMENT; SAFETY; CRYOABLATION;
D O I
10.1016/j.ijcard.2018.07.051
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The aim of this research was to evaluate whether the procedural data, the incidence of complications, and the long-term freedom from atrial fibrillation (AF) recurrences arc influenced by center experience in a paroxysmal AF (PAF) population performing a first-time pulmonary vein isolation (PVI) by cryoballoon ablation (CBA). Methods: A total of 860 patients underwent PVI by CBA. Center experience groups were predefined according to the quartiles of the distribution regarding the amount of performed procedures: 3.1%, 10.6%, 22.7% and 63.6% of patients were respectively followed in each group from 1st (less experienced) to 4th (more experienced) quartile of experience. Results: In the entire population, median procedure and fluoroscopy time were 105 and 25 min, respectively. The median procedure time significantly decreased from 130 to 90 min (P < 0.001) as the center's experience increased. In 47 (5.5%) patients, a peri-procedural complication occurred. As the experience of centers increased, the acute intraprocedural PVI success rate increased (from 94.3% to 98.9%, P = 0.007), whereas there was a tendency towards a decreased incidence of peri-procedure complications (from 7.4% to 4.6%, P= 0.998). The mean 1-year freedom from AF recurrence probability was 78.3%, and the 18-month mean was 68.9% with no difference among the groups with different levels of experience. Conclusion: CBA is a safe and effective treatment for patients with PAF. Peri-procedural complications and procedural times were low in all the analyzed sub-groups, showing a decreasing trend in function of center expertise. The long-term freedom from AF recurrence was not influenced by the level of experience. (C) 2018 Elsevier B.V. All rights reserved.
引用
收藏
页码:130 / 136
页数:7
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