Methods
Study Design :
This retrospective, single-center, observational study was conducted with the goal of improvement of patient care and safety at Orlando Health Heart and Vascular Institute. The study was approved by the Orlando Health Institutional Review Board. Data of patients who underwent either conventional cryoballoon pulmonary vein isolation (CB PVI) or hybrid convergent ablation at Orlando Regional Medical Center from January 2010 through December 2015 were recorded at the time of the procedure. Proceduralists included three electrophysiologists and one cardiothoracic surgeon. Patients in the registry consented to the procedure.
Patient Population :
Patients considered for study were adults with all forms of AF, including patients with prior failed CB PVI. At least one outpatient evaluation 90 days post-procedure (blanking period) was required during follow-up. The following criteria were utilized to determine who was treated by convergent procedure: 1) PAF with failed class I/III antiarrhythmic drug (AAD) therapy and previously failed CB PVI ablation or 2) persistent and LSPAF with failed class I/III AAD willing to undergo the hybrid procedure. The following criteria were utilized to determine who was treated by CB PVI: 1) PAF with failed class I/III AAD or 2) persistent and LSPAF with failed class I/III AAD; unwilling to undergo hybrid procedure. Exclusion criteria included valvular disease that, in the opinion of the surgeon, needed surgical correction. Additionally, prior sternotomy was excluded. Previously documented pericarditis was not an absolute contraindication and all of these cases were successfully ablated.