Standard

Harvard

APA

Vancouver

Author

BibTeX

@article{54cfe8167b0e4728bc788cf075e7bac0,
title = "Predictors of cardiac neuromodulation achieved by cryoballoon ablation performed in patients with atrial fibrillation who were in sinus rhythm before the ablation",
abstract = "BACKGROUND: The impact of pulmonary vein isolation (PVI) performed with cryoballoon (CB) on the intrinsic cardiac autonomic nervous system (ICANS) remains unclear.OBJECTIVE: The purpose of this study was to evaluate the predictors and the clinical meaning of cardiac neuromodulation achieved by CB-ablation as assessed by sinus heart rate (HR) response after the procedure.METHODS: Patients who underwent CB-ablation for drug-resistant atrial fibrillation (AF) from January 2014 to October 2018 were included. Twelve‑leads rest ECG was taken both before and after the procedure. After discharge, patients were scheduled for follow-up visits at 1, 3, 6, and 12 months and 24 h Holter recordings were obtained at each follow-up visit. All documented AF episodes of >30 s were considered as recurrence.RESULTS: Four-hundred seventy-two patients (62.3{\%} male, age 56.7 ± 13.6 years, 97.2{\%} paroxysmal AF) were included. Mean HR before the procedure was 60.17 ± 10.4 bpm, while the morning after the procedure mean HR was 75.48 ± 12.0 bpm. Age at enrollment (R = -0.26; p < 0.001), baseline HR before the CB-A (R = -0.32; p < 0.001), nadir temperature in each right pulmonary vein (R = -0.11, p = 0.022; R = -0.16; p = 0.001) were significantly associated with the ∆HR. At 2-year follow-up, freedom from recurrences was 83.1{\%} for the patients with HR increase ≥15 bpm after CB-A and 66.3{\%} in patients with HR increase ˂15 bpm (p = 0.021).CONCLUSION: Sinus HR increase is a frequent phenomenon after CB-A, that can be predicted by both clinical and procedural factors and that correlates with better outcome after cryo-PVI.",
keywords = "Atrial fibrillation, Cardioneuromodulation, Catheter ablation, Cryoablation, Cryoballoon, Pulmonary vein isolation",
author = "Riccardo Maj and Gianluca Borio and Os{\'o}rio, {Thiago Guimar{\~a}es} and Saverio Iacopino and Erwin Str{\"o}ker and Juan Sieira and Muryo Terasawa and Alessandro Rizzo and Alessio Galli and Varnavas Varnavas and Gezim Bala and Gaetano Paparella and Pedro Brugada and {De Asmundis}, Carlo and Chierchia, {Gian Battista}",
note = "Copyright {\circledC} 2020 Elsevier B.V. All rights reserved.",
year = "2020",
month = "7",
day = "1",
doi = "10.1016/j.ijcard.2020.01.033",
language = "English",
volume = "310",
pages = "86--91",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Predictors of cardiac neuromodulation achieved by cryoballoon ablation performed in patients with atrial fibrillation who were in sinus rhythm before the ablation

AU - Maj, Riccardo

AU - Borio, Gianluca

AU - Osório, Thiago Guimarães

AU - Iacopino, Saverio

AU - Ströker, Erwin

AU - Sieira, Juan

AU - Terasawa, Muryo

AU - Rizzo, Alessandro

AU - Galli, Alessio

AU - Varnavas, Varnavas

AU - Bala, Gezim

AU - Paparella, Gaetano

AU - Brugada, Pedro

AU - De Asmundis, Carlo

AU - Chierchia, Gian Battista

N1 - Copyright © 2020 Elsevier B.V. All rights reserved.

PY - 2020/7/1

Y1 - 2020/7/1

N2 - BACKGROUND: The impact of pulmonary vein isolation (PVI) performed with cryoballoon (CB) on the intrinsic cardiac autonomic nervous system (ICANS) remains unclear.OBJECTIVE: The purpose of this study was to evaluate the predictors and the clinical meaning of cardiac neuromodulation achieved by CB-ablation as assessed by sinus heart rate (HR) response after the procedure.METHODS: Patients who underwent CB-ablation for drug-resistant atrial fibrillation (AF) from January 2014 to October 2018 were included. Twelve‑leads rest ECG was taken both before and after the procedure. After discharge, patients were scheduled for follow-up visits at 1, 3, 6, and 12 months and 24 h Holter recordings were obtained at each follow-up visit. All documented AF episodes of >30 s were considered as recurrence.RESULTS: Four-hundred seventy-two patients (62.3% male, age 56.7 ± 13.6 years, 97.2% paroxysmal AF) were included. Mean HR before the procedure was 60.17 ± 10.4 bpm, while the morning after the procedure mean HR was 75.48 ± 12.0 bpm. Age at enrollment (R = -0.26; p < 0.001), baseline HR before the CB-A (R = -0.32; p < 0.001), nadir temperature in each right pulmonary vein (R = -0.11, p = 0.022; R = -0.16; p = 0.001) were significantly associated with the ∆HR. At 2-year follow-up, freedom from recurrences was 83.1% for the patients with HR increase ≥15 bpm after CB-A and 66.3% in patients with HR increase ˂15 bpm (p = 0.021).CONCLUSION: Sinus HR increase is a frequent phenomenon after CB-A, that can be predicted by both clinical and procedural factors and that correlates with better outcome after cryo-PVI.

AB - BACKGROUND: The impact of pulmonary vein isolation (PVI) performed with cryoballoon (CB) on the intrinsic cardiac autonomic nervous system (ICANS) remains unclear.OBJECTIVE: The purpose of this study was to evaluate the predictors and the clinical meaning of cardiac neuromodulation achieved by CB-ablation as assessed by sinus heart rate (HR) response after the procedure.METHODS: Patients who underwent CB-ablation for drug-resistant atrial fibrillation (AF) from January 2014 to October 2018 were included. Twelve‑leads rest ECG was taken both before and after the procedure. After discharge, patients were scheduled for follow-up visits at 1, 3, 6, and 12 months and 24 h Holter recordings were obtained at each follow-up visit. All documented AF episodes of >30 s were considered as recurrence.RESULTS: Four-hundred seventy-two patients (62.3% male, age 56.7 ± 13.6 years, 97.2% paroxysmal AF) were included. Mean HR before the procedure was 60.17 ± 10.4 bpm, while the morning after the procedure mean HR was 75.48 ± 12.0 bpm. Age at enrollment (R = -0.26; p < 0.001), baseline HR before the CB-A (R = -0.32; p < 0.001), nadir temperature in each right pulmonary vein (R = -0.11, p = 0.022; R = -0.16; p = 0.001) were significantly associated with the ∆HR. At 2-year follow-up, freedom from recurrences was 83.1% for the patients with HR increase ≥15 bpm after CB-A and 66.3% in patients with HR increase ˂15 bpm (p = 0.021).CONCLUSION: Sinus HR increase is a frequent phenomenon after CB-A, that can be predicted by both clinical and procedural factors and that correlates with better outcome after cryo-PVI.

KW - Atrial fibrillation

KW - Cardioneuromodulation

KW - Catheter ablation

KW - Cryoablation

KW - Cryoballoon

KW - Pulmonary vein isolation

UR - http://www.scopus.com/inward/record.url?scp=85078433572&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2020.01.033

DO - 10.1016/j.ijcard.2020.01.033

M3 - Article

C2 - 32001034

VL - 310

SP - 86

EP - 91

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -

ID: 49361199