Jing Voon Chow
Aberdeen Royal Infirmary, UKPresentation Title:
A clinical audit of pulmonary vein isolation with percutaneous balloon cryoablation in refractory atrial fibrillation
Abstract
Objectives: Pulmonary vein isolations is the conventional rhythm-control therapy in treatment-resistant atrial fibrillation (AF). Cryoablation has emerged as a successful therapeutic option as it confers a beneficial effect on procedure time without compromising safety and efficacy due to its single-shot circumferential approach without conduction gap (1), in contrast to the conventional point-by-point application of radiofrequency energy (2). This audit aimed to determine the clinical effectiveness of novel 28mm cryoballoon ablation in pulmonary vein isolations (PVIs) measured by freedom from AF from patients perspectives.
Method: A total of 102 consecutive patients, aged 59.0 + 10.4 with paroxysmal (n=73) and persistent AF (n=29) at Aberdeen Royal Infirmary who underwent de-novo PVIs between January 2012 and January 2019 were enrolled. All data was collected retrospectively via an anonymous catheter ablation database. Men and women constitute 76.5% and 23.5% of the study population respectively.
Result: Primary outcome is AF recurrence, defined as AF >30 seconds including initial blanking period of 3 months while secondary outcome is freedom from AF. Despite recurrence rate of 59/102 (57.8%), 12-month freedom from AF was reported in 52.9% patients and 24-month AF freedom in 69.6% patients after single cryoablation. 19 patients had repeat ablation with radiofrequency approach within 24 months after single cryoablation. AF persists in 12 patients. 88.2% procedures were complication-free.
Conclusion: PVIs with percutaneous balloon cryoablation is an established therapy, attributed to its safety and clinical efficacy. A substantial proportion of patients experienced tremendous improvement in quality of life after single cryoablation and with further intervention during follow-up. This is justified by high incidence of 24-month freedom from AF.
Biography
Jing Voon Chow completed her MbChB from University of Aberdeen, UK. She then started her 2-year Foundation programme in Aberdeen Royal Infirmary and subsequently continue clinical training in Internal Medicine with the aim of pursuing higher specialty training in Cardiology within NHS.
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