Authors

• Andrija Nekić — University of Zagreb, Zagreb, Croatia — ORCID: 0000-0003-1214-8646
• Ivan Prepolec — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0001-5870-202X
• Vedran Pašara — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0002-6587-2315
• Jakov Emanuel Bogdanić — University of Zagreb, Zagreb, Croatia — ORCID: 0000-0001-6656-8289
• Jurica Putrić Posavec — University of Zagreb, Zagreb, Croatia — ORCID: 0000-0003-1667-802X
• Domagoj Kardum — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0001-5202-4061
• Zvonimir Katić — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0002-0493-3188
• Borka Pezo Nikolić — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0002-0504-5238
• Mislav Puljević — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0003-1477-2581
• Davor Puljević — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0003-3603-2242
• Davor Miličić — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0001-9101-1570
• Vedran Velagić — University Hospital Centre Zagreb, Zagreb, Croatia — ORCID: 0000-0001-5425-5840

Keywords

atrial fibrillation, pulmonary vein isolation, cryoballon, treatment outcomes

DOI

Full Text

**The goal:** The goal was to show results of a long-term follow-up following the cryoballoon pulmonary vein isolation in patients with atrial fibrillation (AF). **Patients and Methods**: A total of 126 patients were included in the study of which 77.0% had paroxysmal atrial fibrillation (PAF). Successful treatment outcome was defined as AF recurrence- free survival with stabile sinus rhythm during a 5-year period after the procedure. A treatment failure was defined as symptomatic AF recurrence with ECG verification (12 lead ECG or AF lasting >30s by Holter EKG). The patients on antiarrhythmic therapy and those that underwent a redo pulmonary vein isolation procedure were also included. **Results**: Following cryoballon pulmonary vein isolation in a 5-year period 52.4% of patients were in stable synus rhythm without AF recurrence. With redo pulmonary vein procedures a total of 61.9% of patients was without AF recurrence. Together with antiarrhythmic drugs 57.9% of patients was in sinus rhythm without AF recurrence in a 5-year period. With redo pulmonary vein isolation and antiarrhytmic drugs a total of 73.8% of patients were without AF recurrence. There was statistically significant difference regarding AF recurrence between patients that underwent redo pulmonary vein isolation and those that did not (p=0.006). In patients with PAF, 62.9% remained without AF recurrence and 79.4% who underwent redo procedure. In patients with persistent atrial fibrillation (PersAF), 41.4% was without AF recurrence and 55.1% that underwent a redo procedure. The difference between PAF and PersAF was statistically significant (p=0.009). **Conclusion**: Data from our centre show good long-term results of cryoballoon pulmonary vein isolation in patients with atrial fibrilation. The procedure is especially successful in patients with PAF. (1) The use of redo procedures is justified as it increases long-term success rate.

Literature

1. Heeger CH, Subin B, Wissner E, Fink T, Mathew S, Maurer T, et al. Second-generation cryoballoon-based pulmonary vein isolation: Lessons from a five-year follow-up. Int J Cardiol. 2020 August 1;312:73–80. https://doi.org/10.1016/j.ijcard.2020.03.062