Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Arrhythmia/Electrophysiology
Learning Curve in Cryoballoon Ablation of Atrial Fibrillation
– Eight-Year Experience –
Maciej WójcikAlexander BerkowitschHarald GreisSergey ZaltsbergChristian W. HammHeinz F. PitschnerMalte KunissThomas Neumann
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2014 Volume 78 Issue 7 Pages 1612-1618

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Abstract

Background:We analyzed the procedural experience cryoballoon ablation (CBA) of atrial fibrillation (AF) gained over 8 years in a high-volume centre to understand the influence of the learning curve on feasibility, safety and clinical outcome.Methods and Results:In 424 patients (62% male) with drug-refractory AF, CBA was performed between 2005 and 2012. The analyzed period was divided into 8 calendar years. The endpoint of the study was arrhythmia recurrence after the 3-month blanking period in the 1-year follow-up since the index procedure, in the absence of anti-arrhythmic drugs class I and III. A combined AF type, Left Atrium size, Renal insufficiency, MEtabolic syndrome, cardiomyopathy (ALARMEc) risk score was calculated for each patient. The overall 1-year success rate of a single CBA was 73%. Continuous increase in 1-year success rate was observed with successive years of the study. The gradual improvement in outcome was related to gradual fall in ALARMEc risk score in successive patients. A continuous decrease in fluoroscopy and procedure time was observed in each subsequent year.Conclusions:CBA, followed by the proper selection of patients, facilitates a satisfactory outcome, especially in patients at an early stage of PV-trigger-dependent AF. Still, as with each new technology, it requires completion of a learning curve. (Circ J 2014; 78: 1612–1618)

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© 2014 2013 THE JAPANESE CIRCULATION SOCIETY
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