Cryoballoon ablation for treatment of persistent atrial fibrillation (PerAF) had a single-procedure success rate of 61 percent at one year post-ablation, based on findings presented Aug. 25 during ESC Congress 2018 and simultaneously published in JACC: Clinical Electrophysiology. Patients also experienced significant reduction in arrhythmia-related symptoms and improved quality of life.

A total of 101 patients (62±11 years, 74 percent male, left ventricular ejection fraction 56±8 percent, left atrial diameter 43±5 mm) were included in the multi-center single arm study and were followed at three, six and 12 months with 48-hour Holters at six and 12 months. Quality of life and symptoms were evaluated at both baseline and 12 months. Researchers found significantly fewer patients demonstrated arrhythmia-related symptoms following cryoballoon ablation at 12 months compared with baseline (16 percent vs. 92 percent). Improved quality of life, in terms of physical and mental component scores, was also noted.

"The results of this study complement earlier findings and appear to suggest that a [pulmonary vein isolation]-only approach using exclusively the cryoballoon is a reasonable first line ablation strategy for the treatment of symptomatic PerAF," researchers said.

In a related editorial comment, Suneet Mittal, MD, FACC, suggests the jury is still out, noting that while "the simplicity and low complication rate are admirable and attractive" the question remains whether simplicity comes at the price of long-term success. "In the end, depending on your perspective, the glass remains either half full or half empty when it comes to using the cryoballoon in patients with persistent AFib," Mittal writes.

Clinical Topics: Arrhythmias and Clinical EP, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: ESC18, ESC Congress, Atrial Fibrillation, Ablation Techniques

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