eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
4/2020
vol. 16
 
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abstract:
Original paper

Outcomes of atrial fibrillation ablation program based on single-shot techniques

Marek Jastrzębski
1
,
Grzegorz Kiełbasa
1
,
Kamil Fijorek
2
,
Adam Bednarski
1
,
Aleksander Kusiak
1
,
Tomasz Sondej
1
,
Agnieszka Bednarek
1
,
Pawel Lis
1
,
Agnieszka Olszanecka
1
,
Marek Rajzer
1

1.
First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
2.
Department of Statistics, Cracow University of Economics, Krakow, Poland
Adv Interv Cardiol 2020; 16, 4 (62): 466–473
Online publish date: 2021/01/05
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Introduction
Single-shot techniques such as cryoballoon and multipolar phased pulmonary vein ablation catheter (PVAC) are an alternative to the point-by-point radiofrequency method for atrial fibrillation (AF) ablation. However, there is a lack of data concerning sequential use of single-shot techniques, that is, for both the index and redo ablation. Aim: To assess long-term outcomes of the ‘single-shot techniques only’ AF ablation strategy.

Material and methods
We analyzed all consecutive AF ablations performed over a 10-year period (2009–2019) in a center where a ‘single-shot technique only’ principle was followed from the start of the AF ablation program. Kaplan-Meier AF-free survival curves were calculated and complications were assessed on the basis of our prospectively maintained database.

Results
A total of 597 patients (62.4 ±12.5 years) with paroxysmal (78.1%) or persistent (21.9%) AF entered the study and 655 AF ablation procedures were performed. In 96.5% of redos (n = 58) a different technique (mostly PVAC) was used than for the index ablation (mostly cryoballoon). The Kaplan-Meier estimates of 1, 2 and 5 years freedom from AF were 78.2%, 69.2%, and 56.0%, for the index ablation, and 80.3%, 76.1% and 68.3%, for the redo, respectively. The minor and major complication rates were 8.1%, and 4.0%, respectively.

Conclusions
An AF ablation program based solely on sequential use of two different single-shot techniques for both index and redo procedures is safe and effective. These observations might have important practical implications for new operators/centers starting AF ablation programs and for use of single-shot techniques for redo procedures.

keywords:

atrial fibrillation ablation, redo ablation, single-shot technique, pulmonary vein ablation catheter, cryoballoon

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