d987e2af1f86ba593e8e71a0f7cd6663 pmc_8910954.pdf 3c29fc80a78618dbc9c4db226c2278863979e940 pmc_8910954.pdf 71f8303e39e91852703aa62ae42b22e9fc8487846a3411a079a8c25af6f65f1b pmc_8910954.pdf Title: Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation: Procedural Differences and Results from the Spanish Registry (RECABA) Subject: Introduction: Cryoballoon ablation (CBA) has become a standard treatment for paroxysmal atrial fibrillation (PaAF) but limited data is available for outcomes in patients with persistent atrial fibrillation (PeAF). Methods: We analyzed the first 944 patients included in the Spanish Prospective Multi-center Observation Post-market Registry to compare characteristics and outcomes of patients undergoing CBA for PeAF versus PaAF. Results: A total of 944 patients (57.8 10.4 years; 70.1% male) with AF (27.9% persistent) were prospectively included from 25 centers. PeAF patients were more likely to have structural heart disease (67.7 vs. 11.4%; p < 0.001) and left atrium dilation (72.6 vs. 43.3%; p < 0.001). CBA of PeAF was less likely to be performed under general anesthesia (10.7 vs. 22.2%; p < 0.001), with an arterial line (32.2 vs. 44.6%; p < 0.001) and assisted transeptal puncture (11.9 vs. 17.9%; p = 0.025). During an application, PeAF patients had a longer time to -30 C (35.91 14.20 vs. 34.93 12.87 s; p = 0.021) and a colder balloon nadir temperature during vein isolation (-35.04 9.58 vs. -33.61 10.32 C; p = 0.004), but received fewer bonus freeze applications (30.7 vs. 41.1%; p < 0.001). There were no differences in acute pulmonary vein isolation and procedure-related complications. Overall, 76.7% of patients were free from AF recurrences at 15-month follow-up (78.9% in PaAF vs. 70.9% in PeAF; p = 0.09). Conclusions: Patients with PeAF have a more diseased substrate, and CBA procedures performed in such patients were more simplified, although longer/colder freeze applications were often applied. The acute efficacy/safety profile of CBA was similar between PaAF and PeAF patients, but long-term results were better in PaAF patients. Keywords: persistent atrial fibrillation; cryoballoon procedure; registry Author: Ermengol Vallès, Jesús Jiménez, Julio Martí-Almor, Jorge Toquero, José Miguel Ormaetxe, Alberto Barrera, Arcadio García-Alberola, José Manuel Rubio, Pablo Moriña, Carlos Grande, Maria Fé Arcocha, Rafael Peinado, Rocío Cózar, Julio Hernández, Luisa Pérez-Alvarez, Larraitz Gaztañaga, Angel Ferrero-De Loma-Osorio, Ricardo Ruiz-Granell, Roger Villuendas and Jesús Daniel Martínez-Alday Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Feb 22 13:06:16 2022 CET ModDate: Tue Feb 22 13:09:01 2022 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 421351 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ANMXWZ+VnURWPalladioL Type 1 Custom yes yes no 10 0 IPXRWK+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 LLOXXW+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 ERYKZT+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 FFDGWE+CMSY10 Type 1 Builtin yes yes no 28 0 NRWICF+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 40 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 44 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 48 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 60 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 63 0 CKBPVA+EURM10 Type 1 Builtin yes yes no 88 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 95 0 BCFOND+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 114 0 BCFONF+PalatinoLinotype TrueType WinAnsi yes yes no 117 0 BCFOOG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 120 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-06-13 02:34:00 CEST RepresentationInformation: pmc_8910954.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-03-28 07:25:57 CEST Size: 421351 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 242 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Description of Registry Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Analysis Endpoints Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Cryoballoon Ablation Procedure Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Statistical Analyses Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Population Characteristics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Procedural Characteristics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Clinical and Anatomical Differences between PaAF and PeAF Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Procedural Differences between PaAF vs. PeAF Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Long Term Results among PaAF and PeAF Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Children: Item: Title: Comparison between PaAF and PeAF Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Procedural Differences between PaAF vs. PeAF Patients Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Complications and Acute Results. Comparison with Other Registries Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Long-Term Results. Comparison with Other Studies Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: Limitations Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@ed9d034 Info: Title: Cryoballoon Ablation for Persistent and Paroxysmal Atrial Fibrillation: Procedural Differences and Results from the Spanish Registry (RECABA) Author: Ermengol Vallès, Jesús Jiménez, Julio Martí-Almor, Jorge Toquero, José Miguel Ormaetxe, Alberto Barrera, Arcadio García-Alberola, José Manuel Rubio, Pablo Moriña, Carlos Grande, Maria Fé Arcocha, Rafael Peinado, Rocío Cózar, Julio Hernández, Luisa Pérez-Alvarez, Larraitz Gaztañaga, Angel Ferrero-De Loma-Osorio, Ricardo Ruiz-Granell, Roger Villuendas and Jesús Daniel Martínez-Alday Subject: Introduction: Cryoballoon ablation (CBA) has become a standard treatment for paroxysmal atrial fibrillation (PaAF) but limited data is available for outcomes in patients with persistent atrial fibrillation (PeAF). Methods: We analyzed the first 944 patients included in the Spanish Prospective Multi-center Observation Post-market Registry to compare characteristics and outcomes of patients undergoing CBA for PeAF versus PaAF. Results: A total of 944 patients (57.8 10.4 years; 70.1% male) with AF (27.9% persistent) were prospectively included from 25 centers. PeAF patients were more likely to have structural heart disease (67.7 vs. 11.4%; p < 0.001) and left atrium dilation (72.6 vs. 43.3%; p < 0.001). CBA of PeAF was less likely to be performed under general anesthesia (10.7 vs. 22.2%; p < 0.001), with an arterial line (32.2 vs. 44.6%; p < 0.001) and assisted transeptal puncture (11.9 vs. 17.9%; p = 0.025). During an application, PeAF patients had a longer time to -30 C (35.91 14.20 vs. 34.93 12.87 s; p = 0.021) and a colder balloon nadir temperature during vein isolation (-35.04 9.58 vs. -33.61 10.32 C; p = 0.004), but received fewer bonus freeze applications (30.7 vs. 41.1%; p < 0.001). There were no differences in acute pulmonary vein isolation and procedure-related complications. Overall, 76.7% of patients were free from AF recurrences at 15-month follow-up (78.9% in PaAF vs. 70.9% in PeAF; p = 0.09). Conclusions: Patients with PeAF have a more diseased substrate, and CBA procedures performed in such patients were more simplified, although longer/colder freeze applications were often applied. The acute efficacy/safety profile of CBA was similar between PaAF and PeAF patients, but long-term results were better in PaAF patients. 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