Co-Author(s):
Moritz Rothe, MD
Alena Summ, MD
Schukria Jaqubi, MD
Jaber Abboud, MD
Bianca Dobre, MD
Christina Soether, MD
Bernhard Kaess, PD MD
Joachim Ehrlich, Prof Dr
St. Josefs-Hospital Wiesbaden GmbH
Beethovenstraße 20 65189 Wiesbaden
Introduction | Objectives: Atrial fibrillation (AF) and heart failure (HF) are both of increasing prevalence and mortality. There is evidence that ablation treatment can improve the prognosis of this particular patient subentity but prospective data regarding efficacy and safety of cryoballon pulmonary-vein isolation (cryoPVI) in patients with HF are lacking. The objective was to prospectively compare cryoPVI in patients without and with HF (LVEF ≤ 40%) with respect to efficacy and safety.
Methods: We analyzed consecutive patients who underwent cryoPVI in a single-center cohort between 2018 and 2020. Ablations were performed in a standardized fashion. Follow-up was performed at 3, 6, 12, 18 and 24 months after cryoPVI . Endpoints were: symptomatic AF relapse for efficacy and bleeding, phrenic nerve injury, stroke or death for safety. Statistical analysis was performed by log rank test and Kaplan-Meier method to estimate 12-month event-rate.
Results: We included 464 patients into the analysis, of these 414 had normal LVEF (age 67±10 years, CHA2DS2-VASc Score 2.6±1.5, 54% male) while 50 patients (10.8%) suffered from HF (age 69±11 years, CHA2DS2-VASc Score 2.7±1.5, 55% male). Relapse rates were similar for patients with and without HF (67.5 % vs. 74.4%, P=0.41, Figure). Primary safety end point occurred in form of pericardial effusion or transient phrenic nerve injury in six patients with normal LVEF (1.6%) and one with HF (2%). No deaths or strokes were observed.
Conclusions: CryoPVI is an effective and safe ablation procedure for patients suffering from AF and HF. If there is prognostic benefit from cryoPVI in this context needs to be addressed in prospective trials.AFS 2021-17