4/2020
vol. 16
abstract:
Original paper
Outcomes of atrial fibrillation ablation program based
on single-shot techniques
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
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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