Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience
Background Cryoballoon technology (CB-A) has become a cornerstone of atrial fibrillation (AF) ablation in terms of safety and efficacy. Data regarding CB-A in octogenarians are still scarce and limited to single center experiences. The present study sought to analyze the performances of index CB-A i...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2022-11, Vol.65 (2), p.559-571 |
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| creator | Cecchini, Federico Mugnai, Giacomo Iacopino, Saverio Abugattas, Juan Pablo Adriaenssens, Bert Al-Housari, Maysam Almorad, Alexandre Bala, Gezim Bisignani, Antonio de Asmundis, Carlo De Greef, Yves Maj, Riccardo Osòrio, Thiago G. Pannone, Luigi Schwagten, Bruno Sieira, Juan Sorgente, Antonio Stroker, Erwin Wolf, Michael Chierchia, Gian-Battista |
| description | Background
Cryoballoon technology (CB-A) has become a cornerstone of atrial fibrillation (AF) ablation in terms of safety and efficacy. Data regarding CB-A in octogenarians are still scarce and limited to single center experiences. The present study sought to analyze the performances of index CB-A in patients older than 80 years-old referring to 3 high-volume European centers.
Methods and results
We retrospectively enrolled 95 patients with a median age of 81 [80, 83] years. 62 (65.3%) patients presented with paroxysmal AF and 33 (33.7%) with persistent AF. Mean procedure and fluoroscopy times were 73.8 ± 25.2 and 15.3 ± 7.5 min, respectively. At 12 months and 24 months of follow-up, the overall freedom from AF was 81.1% and 66.6%, respectively. When divided for AF type, freedom from AF was higher in patients with paroxysmal AF (
p
= 0.007). Cryoballoon ablation was able to significantly improve AF-related symptoms as proven by the significant decrease in EHRA score during the follow-up (
p
|
| doi_str_mv | 10.1007/s10840-022-01313-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2693771731</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2732911978</sourcerecordid><originalsourceid>FETCH-LOGICAL-c282t-836125168b711dd6085f1ecd0265a55dc6846cc31c17e983c8df136331c660bb3</originalsourceid><addsrcrecordid>eNp9UctqHDEQFMGG2Gv_QE6CXHKRo5asx-QWTGwHDD4kAd-ERtNaZGaljTQLu38fJWsI-OBTF91VRdFFyAfgV8C5-dyA22vOuBCMgwTJ9u_IGSgjmFWDOulYWsmsUU_vyXlrz5zzgQt9RvY_fMTlQH2e6Fzymi1YNxRjTMGHAy2Rhnooo5_nUjL14-yX1EEslfqlJj_TmMaa5pd9yrSEpawx-37M7Qv1dLOblxQwd2eK-y3WhDngBTmNfm54-TJX5Nftt5839-zh8e77zdcHFoQVC7NSg1Cg7WgApklzqyJgmHp45ZWagrbXOgQJAQwOVgY7RZBa9oXWfBzlinw6-m5r-b3DtrhNagF74Ixl15zQgzQGTH_ainx8RX0uu5p7OieMFAPAYGxniSMr1NJaxei2NW18PTjg7m8Z7liG62W4f2W4fRfJo6h1cl5j_W_9huoPcKSOTg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2732911978</pqid></control><display><type>article</type><title>Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience</title><source>Springer Online Journals Complete</source><creator>Cecchini, Federico ; Mugnai, Giacomo ; Iacopino, Saverio ; Abugattas, Juan Pablo ; Adriaenssens, Bert ; Al-Housari, Maysam ; Almorad, Alexandre ; Bala, Gezim ; Bisignani, Antonio ; de Asmundis, Carlo ; De Greef, Yves ; Maj, Riccardo ; Osòrio, Thiago G. ; Pannone, Luigi ; Schwagten, Bruno ; Sieira, Juan ; Sorgente, Antonio ; Stroker, Erwin ; Wolf, Michael ; Chierchia, Gian-Battista</creator><creatorcontrib>Cecchini, Federico ; Mugnai, Giacomo ; Iacopino, Saverio ; Abugattas, Juan Pablo ; Adriaenssens, Bert ; Al-Housari, Maysam ; Almorad, Alexandre ; Bala, Gezim ; Bisignani, Antonio ; de Asmundis, Carlo ; De Greef, Yves ; Maj, Riccardo ; Osòrio, Thiago G. ; Pannone, Luigi ; Schwagten, Bruno ; Sieira, Juan ; Sorgente, Antonio ; Stroker, Erwin ; Wolf, Michael ; Chierchia, Gian-Battista</creatorcontrib><description>Background
Cryoballoon technology (CB-A) has become a cornerstone of atrial fibrillation (AF) ablation in terms of safety and efficacy. Data regarding CB-A in octogenarians are still scarce and limited to single center experiences. The present study sought to analyze the performances of index CB-A in patients older than 80 years-old referring to 3 high-volume European centers.
Methods and results
We retrospectively enrolled 95 patients with a median age of 81 [80, 83] years. 62 (65.3%) patients presented with paroxysmal AF and 33 (33.7%) with persistent AF. Mean procedure and fluoroscopy times were 73.8 ± 25.2 and 15.3 ± 7.5 min, respectively. At 12 months and 24 months of follow-up, the overall freedom from AF was 81.1% and 66.6%, respectively. When divided for AF type, freedom from AF was higher in patients with paroxysmal AF (
p
= 0.007). Cryoballoon ablation was able to significantly improve AF-related symptoms as proven by the significant decrease in EHRA score during the follow-up (
p
< 0.0001). Phrenic nerve palsy occurred in 8 (8.5%) patients and always resolved during the procedure without affecting procedural outcome. Two major complications occurred (2.1%); one patient experienced pneumonia, successfully treated with antibiotics and non-invasive mechanical ventilation, the latter one experienced acute kidney failure secondary to urosepsis successfully treated by renal replacement therapy.
Conclusions
The present study showed that CB-A is a feasible and effective procedure among octogenarians with a low complication rate. Contemporarily, CB-A can help to alleviate arrhythmia-related symptoms also among this group of subjects.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-022-01313-x</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Ablation ; Antibiotics ; Arrhythmia ; Cardiac arrhythmia ; Cardiology ; Complications ; Effectiveness ; Fibrillation ; Fluoroscopy ; Mechanical ventilation ; Medicine ; Medicine & Public Health ; Paralysis ; Phrenic nerve ; Renal failure ; Safety</subject><ispartof>Journal of interventional cardiac electrophysiology, 2022-11, Vol.65 (2), p.559-571</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c282t-836125168b711dd6085f1ecd0265a55dc6846cc31c17e983c8df136331c660bb3</citedby><cites>FETCH-LOGICAL-c282t-836125168b711dd6085f1ecd0265a55dc6846cc31c17e983c8df136331c660bb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-022-01313-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-022-01313-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Cecchini, Federico</creatorcontrib><creatorcontrib>Mugnai, Giacomo</creatorcontrib><creatorcontrib>Iacopino, Saverio</creatorcontrib><creatorcontrib>Abugattas, Juan Pablo</creatorcontrib><creatorcontrib>Adriaenssens, Bert</creatorcontrib><creatorcontrib>Al-Housari, Maysam</creatorcontrib><creatorcontrib>Almorad, Alexandre</creatorcontrib><creatorcontrib>Bala, Gezim</creatorcontrib><creatorcontrib>Bisignani, Antonio</creatorcontrib><creatorcontrib>de Asmundis, Carlo</creatorcontrib><creatorcontrib>De Greef, Yves</creatorcontrib><creatorcontrib>Maj, Riccardo</creatorcontrib><creatorcontrib>Osòrio, Thiago G.</creatorcontrib><creatorcontrib>Pannone, Luigi</creatorcontrib><creatorcontrib>Schwagten, Bruno</creatorcontrib><creatorcontrib>Sieira, Juan</creatorcontrib><creatorcontrib>Sorgente, Antonio</creatorcontrib><creatorcontrib>Stroker, Erwin</creatorcontrib><creatorcontrib>Wolf, Michael</creatorcontrib><creatorcontrib>Chierchia, Gian-Battista</creatorcontrib><title>Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><description>Background
Cryoballoon technology (CB-A) has become a cornerstone of atrial fibrillation (AF) ablation in terms of safety and efficacy. Data regarding CB-A in octogenarians are still scarce and limited to single center experiences. The present study sought to analyze the performances of index CB-A in patients older than 80 years-old referring to 3 high-volume European centers.
Methods and results
We retrospectively enrolled 95 patients with a median age of 81 [80, 83] years. 62 (65.3%) patients presented with paroxysmal AF and 33 (33.7%) with persistent AF. Mean procedure and fluoroscopy times were 73.8 ± 25.2 and 15.3 ± 7.5 min, respectively. At 12 months and 24 months of follow-up, the overall freedom from AF was 81.1% and 66.6%, respectively. When divided for AF type, freedom from AF was higher in patients with paroxysmal AF (
p
= 0.007). Cryoballoon ablation was able to significantly improve AF-related symptoms as proven by the significant decrease in EHRA score during the follow-up (
p
< 0.0001). Phrenic nerve palsy occurred in 8 (8.5%) patients and always resolved during the procedure without affecting procedural outcome. Two major complications occurred (2.1%); one patient experienced pneumonia, successfully treated with antibiotics and non-invasive mechanical ventilation, the latter one experienced acute kidney failure secondary to urosepsis successfully treated by renal replacement therapy.
Conclusions
The present study showed that CB-A is a feasible and effective procedure among octogenarians with a low complication rate. Contemporarily, CB-A can help to alleviate arrhythmia-related symptoms also among this group of subjects.</description><subject>Ablation</subject><subject>Antibiotics</subject><subject>Arrhythmia</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Complications</subject><subject>Effectiveness</subject><subject>Fibrillation</subject><subject>Fluoroscopy</subject><subject>Mechanical ventilation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Paralysis</subject><subject>Phrenic nerve</subject><subject>Renal failure</subject><subject>Safety</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9UctqHDEQFMGG2Gv_QE6CXHKRo5asx-QWTGwHDD4kAd-ERtNaZGaljTQLu38fJWsI-OBTF91VRdFFyAfgV8C5-dyA22vOuBCMgwTJ9u_IGSgjmFWDOulYWsmsUU_vyXlrz5zzgQt9RvY_fMTlQH2e6Fzymi1YNxRjTMGHAy2Rhnooo5_nUjL14-yX1EEslfqlJj_TmMaa5pd9yrSEpawx-37M7Qv1dLOblxQwd2eK-y3WhDngBTmNfm54-TJX5Nftt5839-zh8e77zdcHFoQVC7NSg1Cg7WgApklzqyJgmHp45ZWagrbXOgQJAQwOVgY7RZBa9oXWfBzlinw6-m5r-b3DtrhNagF74Ixl15zQgzQGTH_ainx8RX0uu5p7OieMFAPAYGxniSMr1NJaxei2NW18PTjg7m8Z7liG62W4f2W4fRfJo6h1cl5j_W_9huoPcKSOTg</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Cecchini, Federico</creator><creator>Mugnai, Giacomo</creator><creator>Iacopino, Saverio</creator><creator>Abugattas, Juan Pablo</creator><creator>Adriaenssens, Bert</creator><creator>Al-Housari, Maysam</creator><creator>Almorad, Alexandre</creator><creator>Bala, Gezim</creator><creator>Bisignani, Antonio</creator><creator>de Asmundis, Carlo</creator><creator>De Greef, Yves</creator><creator>Maj, Riccardo</creator><creator>Osòrio, Thiago G.</creator><creator>Pannone, Luigi</creator><creator>Schwagten, Bruno</creator><creator>Sieira, Juan</creator><creator>Sorgente, Antonio</creator><creator>Stroker, Erwin</creator><creator>Wolf, Michael</creator><creator>Chierchia, Gian-Battista</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20221101</creationdate><title>Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience</title><author>Cecchini, Federico ; Mugnai, Giacomo ; Iacopino, Saverio ; Abugattas, Juan Pablo ; Adriaenssens, Bert ; Al-Housari, Maysam ; Almorad, Alexandre ; Bala, Gezim ; Bisignani, Antonio ; de Asmundis, Carlo ; De Greef, Yves ; Maj, Riccardo ; Osòrio, Thiago G. ; Pannone, Luigi ; Schwagten, Bruno ; Sieira, Juan ; Sorgente, Antonio ; Stroker, Erwin ; Wolf, Michael ; Chierchia, Gian-Battista</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c282t-836125168b711dd6085f1ecd0265a55dc6846cc31c17e983c8df136331c660bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Ablation</topic><topic>Antibiotics</topic><topic>Arrhythmia</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Complications</topic><topic>Effectiveness</topic><topic>Fibrillation</topic><topic>Fluoroscopy</topic><topic>Mechanical ventilation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Paralysis</topic><topic>Phrenic nerve</topic><topic>Renal failure</topic><topic>Safety</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cecchini, Federico</creatorcontrib><creatorcontrib>Mugnai, Giacomo</creatorcontrib><creatorcontrib>Iacopino, Saverio</creatorcontrib><creatorcontrib>Abugattas, Juan Pablo</creatorcontrib><creatorcontrib>Adriaenssens, Bert</creatorcontrib><creatorcontrib>Al-Housari, Maysam</creatorcontrib><creatorcontrib>Almorad, Alexandre</creatorcontrib><creatorcontrib>Bala, Gezim</creatorcontrib><creatorcontrib>Bisignani, Antonio</creatorcontrib><creatorcontrib>de Asmundis, Carlo</creatorcontrib><creatorcontrib>De Greef, Yves</creatorcontrib><creatorcontrib>Maj, Riccardo</creatorcontrib><creatorcontrib>Osòrio, Thiago G.</creatorcontrib><creatorcontrib>Pannone, Luigi</creatorcontrib><creatorcontrib>Schwagten, Bruno</creatorcontrib><creatorcontrib>Sieira, Juan</creatorcontrib><creatorcontrib>Sorgente, Antonio</creatorcontrib><creatorcontrib>Stroker, Erwin</creatorcontrib><creatorcontrib>Wolf, Michael</creatorcontrib><creatorcontrib>Chierchia, Gian-Battista</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cecchini, Federico</au><au>Mugnai, Giacomo</au><au>Iacopino, Saverio</au><au>Abugattas, Juan Pablo</au><au>Adriaenssens, Bert</au><au>Al-Housari, Maysam</au><au>Almorad, Alexandre</au><au>Bala, Gezim</au><au>Bisignani, Antonio</au><au>de Asmundis, Carlo</au><au>De Greef, Yves</au><au>Maj, Riccardo</au><au>Osòrio, Thiago G.</au><au>Pannone, Luigi</au><au>Schwagten, Bruno</au><au>Sieira, Juan</au><au>Sorgente, Antonio</au><au>Stroker, Erwin</au><au>Wolf, Michael</au><au>Chierchia, Gian-Battista</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><date>2022-11-01</date><risdate>2022</risdate><volume>65</volume><issue>2</issue><spage>559</spage><epage>571</epage><pages>559-571</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Background
Cryoballoon technology (CB-A) has become a cornerstone of atrial fibrillation (AF) ablation in terms of safety and efficacy. Data regarding CB-A in octogenarians are still scarce and limited to single center experiences. The present study sought to analyze the performances of index CB-A in patients older than 80 years-old referring to 3 high-volume European centers.
Methods and results
We retrospectively enrolled 95 patients with a median age of 81 [80, 83] years. 62 (65.3%) patients presented with paroxysmal AF and 33 (33.7%) with persistent AF. Mean procedure and fluoroscopy times were 73.8 ± 25.2 and 15.3 ± 7.5 min, respectively. At 12 months and 24 months of follow-up, the overall freedom from AF was 81.1% and 66.6%, respectively. When divided for AF type, freedom from AF was higher in patients with paroxysmal AF (
p
= 0.007). Cryoballoon ablation was able to significantly improve AF-related symptoms as proven by the significant decrease in EHRA score during the follow-up (
p
< 0.0001). Phrenic nerve palsy occurred in 8 (8.5%) patients and always resolved during the procedure without affecting procedural outcome. Two major complications occurred (2.1%); one patient experienced pneumonia, successfully treated with antibiotics and non-invasive mechanical ventilation, the latter one experienced acute kidney failure secondary to urosepsis successfully treated by renal replacement therapy.
Conclusions
The present study showed that CB-A is a feasible and effective procedure among octogenarians with a low complication rate. Contemporarily, CB-A can help to alleviate arrhythmia-related symptoms also among this group of subjects.</abstract><cop>New York</cop><pub>Springer US</pub><doi>10.1007/s10840-022-01313-x</doi><tpages>13</tpages></addata></record> |
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| ispartof | Journal of interventional cardiac electrophysiology, 2022-11, Vol.65 (2), p.559-571 |
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| source | Springer Online Journals Complete |
| subjects | Ablation Antibiotics Arrhythmia Cardiac arrhythmia Cardiology Complications Effectiveness Fibrillation Fluoroscopy Mechanical ventilation Medicine Medicine & Public Health Paralysis Phrenic nerve Renal failure Safety |
| title | Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience |
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