Volume 28, Issue 9 pp. 1021-1027
ORIGINAL ARTICLE

Clinical assessment of cryoballoon ablation in cases with atrial fibrillation and a left common pulmonary vein

Takatoshi Shigeta MD

Takatoshi Shigeta MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Kaoru Okishige MD, FHRS, FACC

Corresponding Author

Kaoru Okishige MD, FHRS, FACC

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

Correspondence

Kaoru Okishige, MD, Heart Center, Yokohama-City Bay Red Cross Hospital, 3-12-1, Shin-yamashita, Naka-ward, Yokohama-City, Kanagawa 231–8682, Japan.

Email: [email protected]

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Yasuteru Yamauchi MD

Yasuteru Yamauchi MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Hideshi Aoyagi MD

Hideshi Aoyagi MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Tomofumi Nakamura MD

Tomofumi Nakamura MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Mitsumi Yamashita MD

Mitsumi Yamashita MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Takuro Nishimura MD

Takuro Nishimura MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Naruhiko Ito MD

Naruhiko Ito MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Yusuke Tsuchiya MD

Yusuke Tsuchiya MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Mitsutoshi Asano MD

Mitsutoshi Asano MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Tsukasa Shimura MD

Tsukasa Shimura MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Hidetoshi Suzuki MD

Hidetoshi Suzuki MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Manabu Kurabayashi MD

Manabu Kurabayashi MD

Heart Center, Yokohama-City Bay Red Cross Hospital, Yokohama City, Japan

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Takehiko Keida MD

Takehiko Keida MD

Cardiology, Edogawa Hospital, Tokyo, Japan

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Tetsuo Sasano MD

Tetsuo Sasano MD

Arrhythmia Center, Tokyo Medical and Dental University, Tokyo, Japan

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Kenzo Hirao MD

Kenzo Hirao MD

Arrhythmia Center, Tokyo Medical and Dental University, Tokyo, Japan

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First published: 01 June 2017
Citations: 35

Disclosures: None.

Abstract

Introduction

Pulmonary vein isolation (PVI) using a cryoballoon (CB) is a useful tool for treating atrial fibrillation (AF); however, the clinical efficacy of the CB has never been fully investigated in patients with a left common pulmonary vein (LCPV).

Methods and results

Three hundred twenty-four consecutive paroxysmal AF patients underwent PVI with a CB. Three-dimensional computed tomography was performed in all patients before the ablation. The clinical outcomes of the AF ablation between patients with (Group A) and without an LCPV (Group B) were compared. An LCPV was observed in 27 (8%) patients. There were no significant differences in the procedure time (149 ± 45 min vs. 143 ± 40 min, respectively; P = 0.42) and percentage needing touch up ablation between the 2 groups (26% vs. 20%, respectively; P = 0.45). At a mean follow-up of 454 ± 195 days, 282 of 324 (87%) patients were free from any atrial tachyarrhythmias (ATs) after a single procedure. Twenty out of 27 (74%) Group A patients and 262 of 297 (88%) Group B patients were free from ATs (15-month Kaplan–Meier event free rate estimates, 77% and 89%, respectively; P = 0.02). A multivariate analysis identified the presence of an LCPV and the left atrial diameter as reliable predictors of recurrent ATs.

Conclusions

The long-term clinical outcomes of ablation of AF with the CB was worse in patients with an LCPV than in those without. The presence of an LCPV and the LA size seemed to be reliable predictors of a worse outcome.

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