Latin-American Experience In Cryoablation Of Paroxysmal And Persistent Atrial Fibrillation Using Second Generation Cryo-Balloon. Acute Success And 12 Months Of Follow-Up

Objective: Catheter ablation has become a usual technique to treat atrial fibrillation (AF). Medium-term results of prospective and multicenter data concerning pulmonary veins cryoablation in Latin America are limited. The objective is to assess the safety and efficacy of ablation by second generation cryoballoon in patients with paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PerAF) in Latin America. Method: We evaluate the characteristics of the procedure and the acute and 12-month results. Inclusion criteria include patients over 18 years old with AF who have a planned procedure of pulmonary veins isolation with second generation cryoballoon. Treatment failure was defined as any episode of AF, atrial flutter or atrial tachycardia greater than 30 seconds outside the 90-day blinded period. Results: A total of 218 patients (57 +/- 11 years, 66.5% men, CHA2DS2-VASc 1.2 +/- 1.1) were included in the study. Of these, 83.9% evidenced PAF, 12.8% PerAF, and 2.3% long-standing PerAF. Fifteen with history of atrial flutter. Most patients had failed at least one antiarrhythmic drug (89.4%). The acute success of the procedure was obtained in 211 patients (96.8%). The average procedure time was 73.2 +/- 26.7 min, the fluoroscopy time was 21.4 +/- 23.9 min, and the total lab occupancy time was 114.6 +/- 41.3 min. During the 12-month follow-up, freedom from AF recurrence was 88.6% in PAF, and 73.1% in PerAF. Twenty-one patients experienced device or procedure-related complications (9.6%). Conclusions: These results support pulmonary veins electrical isolation with cryoballoon as an effective treatment for AF in Latin America.