loading page

Cryoballoon ablation of the left atrial posterior wall reduces recurrence of persistent atrial fibrillation in patients with non-paroxysmal atrial fibrillation
  • +7
  • Takatoshi Shigeta,
  • Yasuteru Yamauchi,
  • Yuichiro Sagawa,
  • Atsuhito Oda,
  • Shinichi Tachibana,
  • Kouzi Sudo,
  • Rena Nakamura,
  • Kaoru Okishige,
  • Masahiko Goya,
  • Tetsuo Sasano
Takatoshi Shigeta
Japan Red Cross Yokohama City Bay Hospital
Author Profile
Yasuteru Yamauchi
Japan Red Cross Yokohama City Bay Hospital
Author Profile
Yuichiro Sagawa
Japan Red Cross Yokohama City Bay Hospital
Author Profile
Atsuhito Oda
Japan Red Cross Yokohama City Bay Hospital
Author Profile
Shinichi Tachibana
Japan Red Cross Yokohama City Bay Hospital
Author Profile
Kouzi Sudo
Japan Red Cross Yokohama City Bay Hospital
Author Profile
Rena Nakamura
Japan Red Cross Yokohama-city Bay Hospital
Author Profile
Kaoru Okishige
Japan Red Cross Yokohama City Bay Hospital
Author Profile
Masahiko Goya
Tokyo Medical and Dental University
Author Profile
Tetsuo Sasano
Tokyo Medical and Dental University
Author Profile

Abstract

Introduction: Detailed clinical outcomes of cryoballoon ablation of the left atrial (LA) posterior wall (LAPW) in patients with non-paroxysmal atrial fibrillation (AF) have not been fully examined. Methods: We analyzed the outcomes of 191 patients with non-paroxysmal AF, of whom 135 underwent cryoballoon ablation of the LAPW including the LA roof in addition to pulmonary vein isolation with a cryoballoon. Results: Complete conduction block at the LA roof was obtained in 97.0% (131/135) of patients and LAPW was isolated in 85.2% (115/135) of patients. Over 372 days (range, 182–450 days) of follow-up, atrial arrhythmia recurrence was observed in 55 (40.7%) patients, and atrial tachycardia (AT) recurrence accounted for 25.5% of cases. The prevalence of LA roof cryoballoon ablation tended to be higher in patients without recurrence than those with (74.3% vs. 61.8%, respectively; p=0.11), especially those with persistent AF recurrence (74.5% vs. 46.2%, p=0.01). Multivariate analysis revealed that cryoballoon ablation of the LA roof was a predictor of freedom from persistent AF recurrence and that it was not associated with AT recurrence. Durable LA roof lesions were confirmed in 18 (72.0%) of 25 patients who underwent redo ablation. Conclusion: Cryoballoon ablation of the LAPW leads to a sufficient acute success rate of complete conduction block and durable lesions of the LA roof without increasing the risk of AT recurrence. The prevalence of persistent AF recurrence decreases after additional cryoballoon ablation of the LAPW in patients with non-paroxysmal AF.