Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice?
Background: Ablation of atrial fibrillation (AF), both cryoablation ablation (CBA) and radiofrequency catheter ablation (RFCA), have demonstrated to be safe and effective. About 1 in 3 patients may face a redo due to recurrence and the best technique is unknown. The aim of this study is to assess th...
| Autores: | , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.uam.es:10486/754180 |
| Acceso en línea: | https://hdl.handle.net/10486/754180 https://dx.doi.org/10.5603/CJ.a2023.0017 |
| Access Level: | acceso abierto |
| Palabra clave: | cryoablation atrial fibrillation catheter ablation radiofrequency catheter ablation Medicina |
| id |
ES_5f660fc8a6bf4c7b41faaaa783e2f36d |
|---|---|
| oai_identifier_str |
oai:repositorio.uam.es:10486/754180 |
| network_acronym_str |
ES |
| network_name_str |
España |
| repository_id_str |
|
| spelling |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice?Álvarez-Ortega, CarlosSolórzano Guillén, César RainerBarrera Cordero, AlbertoToquero Ramos, Jorge EnriqueMartínez-Alday, Jesús DanielGrande Morales, Carlos EugenioRodríguez González, AníbalGarcía-Alberola, ArcadioPérez Álvarez, LuisaFerrero De Loma Osorio, ÁngelHernández Afosno, Julio SalvadorCózar León, RocíoCano Pérez, ÓscarTrucco, María EmilcePeinado Peinado, Rafaelcryoablationatrial fibrillationcatheter ablationradiofrequency catheter ablationMedicinaBackground: Ablation of atrial fibrillation (AF), both cryoablation ablation (CBA) and radiofrequency catheter ablation (RFCA), have demonstrated to be safe and effective. About 1 in 3 patients may face a redo due to recurrence and the best technique is unknown. The aim of this study is to assess the efficacy of CBA as a repeat procedure in patients with prior CBA or RFCA. Methods: A nation-wide CBA registry (RECABA) was analyzed and patients were compared who had previously undergone CBA (Prior-CB) or RFCA (Prior-RF). The primary endpoint was AF recurrence at 12 months after a 3-month blanking period. A survival analysis was performed, univariate and multivariate Cox models were also built. Results: Seventy-four patients were included. Thirty-three (44.6%) were in the Prior-CB group and 41 (55.4%) in the Prior-RF. There were more reconnected pulmonary veins in the Prior-RF than in Prior-CB group (40.4% vs.16.5%, p = 0.0001). The 12-month Kaplan–Meier estimate of freedom from AF recurrence after the blanking period was 61.0% (95% confidence interval [CI] 41.4–75.8%) in the Prior-CB, and 89.2% (95% CI 73.6–95.9%) in the Prior-RF group (p = 0.002). Multivariate Cox regression pointed Prior-CB as the sole independent predictor of AF recurrence, with an adjusted HR of 2.67 (95% CI 1.05–6.79). Conclusions: Repeat CBA shows higher rates of AF recurrences compared to CBA after a previous RFCA despite presenting less reconnected veins at the procedure. These data suggest that patients with AF recurrence after CBA may benefit from other ablation techniques after a recurrence. RECABA is registered at clinicaltrials.gov with the Unique Identifier NCT02785991Via MedicaFacultad de MedicinaDepartamento de Medicina20242024-03-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10486/754180https://dx.doi.org/10.5603/CJ.a2023.001736908163reponame:Biblos-e Archivo. Repositorio Institucional de la UAMinstname:Universidad Autónoma de MadridInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositorio.uam.es:10486/7541802026-06-23T12:46:27Z |
| dc.title.none.fl_str_mv |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? |
| title |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? |
| spellingShingle |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? Álvarez-Ortega, Carlos cryoablation atrial fibrillation catheter ablation radiofrequency catheter ablation Medicina |
| title_short |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? |
| title_full |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? |
| title_fullStr |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? |
| title_full_unstemmed |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? |
| title_sort |
Repeat cryoablation as a redo procedure for atrial fibrillation ablation: Is it a good choice? |
| dc.creator.none.fl_str_mv |
Álvarez-Ortega, Carlos Solórzano Guillén, César Rainer Barrera Cordero, Alberto Toquero Ramos, Jorge Enrique Martínez-Alday, Jesús Daniel Grande Morales, Carlos Eugenio Rodríguez González, Aníbal García-Alberola, Arcadio Pérez Álvarez, Luisa Ferrero De Loma Osorio, Ángel Hernández Afosno, Julio Salvador Cózar León, Rocío Cano Pérez, Óscar Trucco, María Emilce Peinado Peinado, Rafael |
| author |
Álvarez-Ortega, Carlos |
| author_facet |
Álvarez-Ortega, Carlos Solórzano Guillén, César Rainer Barrera Cordero, Alberto Toquero Ramos, Jorge Enrique Martínez-Alday, Jesús Daniel Grande Morales, Carlos Eugenio Rodríguez González, Aníbal García-Alberola, Arcadio Pérez Álvarez, Luisa Ferrero De Loma Osorio, Ángel Hernández Afosno, Julio Salvador Cózar León, Rocío Cano Pérez, Óscar Trucco, María Emilce Peinado Peinado, Rafael |
| author_role |
author |
| author2 |
Solórzano Guillén, César Rainer Barrera Cordero, Alberto Toquero Ramos, Jorge Enrique Martínez-Alday, Jesús Daniel Grande Morales, Carlos Eugenio Rodríguez González, Aníbal García-Alberola, Arcadio Pérez Álvarez, Luisa Ferrero De Loma Osorio, Ángel Hernández Afosno, Julio Salvador Cózar León, Rocío Cano Pérez, Óscar Trucco, María Emilce Peinado Peinado, Rafael |
| author2_role |
author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Facultad de Medicina Departamento de Medicina |
| dc.subject.none.fl_str_mv |
cryoablation atrial fibrillation catheter ablation radiofrequency catheter ablation Medicina |
| topic |
cryoablation atrial fibrillation catheter ablation radiofrequency catheter ablation Medicina |
| description |
Background: Ablation of atrial fibrillation (AF), both cryoablation ablation (CBA) and radiofrequency catheter ablation (RFCA), have demonstrated to be safe and effective. About 1 in 3 patients may face a redo due to recurrence and the best technique is unknown. The aim of this study is to assess the efficacy of CBA as a repeat procedure in patients with prior CBA or RFCA. Methods: A nation-wide CBA registry (RECABA) was analyzed and patients were compared who had previously undergone CBA (Prior-CB) or RFCA (Prior-RF). The primary endpoint was AF recurrence at 12 months after a 3-month blanking period. A survival analysis was performed, univariate and multivariate Cox models were also built. Results: Seventy-four patients were included. Thirty-three (44.6%) were in the Prior-CB group and 41 (55.4%) in the Prior-RF. There were more reconnected pulmonary veins in the Prior-RF than in Prior-CB group (40.4% vs.16.5%, p = 0.0001). The 12-month Kaplan–Meier estimate of freedom from AF recurrence after the blanking period was 61.0% (95% confidence interval [CI] 41.4–75.8%) in the Prior-CB, and 89.2% (95% CI 73.6–95.9%) in the Prior-RF group (p = 0.002). Multivariate Cox regression pointed Prior-CB as the sole independent predictor of AF recurrence, with an adjusted HR of 2.67 (95% CI 1.05–6.79). Conclusions: Repeat CBA shows higher rates of AF recurrences compared to CBA after a previous RFCA despite presenting less reconnected veins at the procedure. These data suggest that patients with AF recurrence after CBA may benefit from other ablation techniques after a recurrence. RECABA is registered at clinicaltrials.gov with the Unique Identifier NCT02785991 |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2024 2024-03-01 |
| dc.type.none.fl_str_mv |
research article http://purl.org/coar/resource_type/c_2df8fbb1 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/10486/754180 https://dx.doi.org/10.5603/CJ.a2023.0017 36908163 |
| url |
https://hdl.handle.net/10486/754180 https://dx.doi.org/10.5603/CJ.a2023.0017 |
| identifier_str_mv |
36908163 |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.rights.openaire.fl_str_mv |
info:eu-repo/semantics/openAccess |
| rights_invalid_str_mv |
open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| eu_rights_str_mv |
openAccess |
| dc.format.none.fl_str_mv |
application/pdf |
| dc.publisher.none.fl_str_mv |
Via Medica |
| publisher.none.fl_str_mv |
Via Medica |
| dc.source.none.fl_str_mv |
reponame:Biblos-e Archivo. Repositorio Institucional de la UAM instname:Universidad Autónoma de Madrid |
| instname_str |
Universidad Autónoma de Madrid |
| reponame_str |
Biblos-e Archivo. Repositorio Institucional de la UAM |
| collection |
Biblos-e Archivo. Repositorio Institucional de la UAM |
| repository.name.fl_str_mv |
|
| repository.mail.fl_str_mv |
|
| _version_ |
1869409203533119488 |
| score |
15.81155 |