Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
12-months efficacy of cryoballoon ablation for atrial fibrillation performed in local hospitals. Results of the German Register on cryoballoon-ablation in local hospitals (Regional).
R. Hoffmann1, U. Parade2, H. Bauerle3, K.-D. Winter4, U. Rauschenbach5, K. Mischke6, C. Schaefer7, K.-J. Gutleben8, O. R. Rana9, T. Willich10, M. Schlößer11, A. Rötzer12, O.-A. Breithardt13, S. Middendorf14, R. Grove15, J. O. Mosa16, J. Krug17, G. Imnadze18, E. Saygili19, J. Michaelsen1, für die Studiengruppe: Regional
1Medizinische Klinik - Kardiologie, St. Bonifatius-Hospital gGmbH, Lingen (Ems); 2Klinik für Innere Medizin, Kardiologie, Nephrologie & internistische Intensivmedizin, Kliniken Ludwigsburg-Bietigheim gGmbH, Ludwigsburg; 3Medizinische Klinik II, Medizin Campus Bodensee, Friedrichshafen; 4Klinik für Kardiologie, Hermann-Josef-Krankenhaus, Erkelenz; 5Medizinische Klinik, DIAKO Flensburg, Flensburg; 6Medizinische Klinik I, Leopoldina-Krankenhaus Schweinfurt, Schweinfurt; 7Klinik für Kardiologie, Elbe Klinikum Buxtehude, Buxtehude; 8Kardiologie, Klinikum Herford, Herford; 9Kardiologie – Elektrophysiologie und Devicetherapie, Sana Kliniken Duisburg, Duisburg; 10Kardiologische Gemeinschaftspraxis Brilon, Brilon; 11Innere Medizin und Kardiologie, Dreifaltigkeits-Hospital gem. GmbH, Lippstadt; 12Med. Klinik - Kardiologie und Kreislauferkrankungen, medius KLINIK, Ostfildern; 13Kardiologie & Rhythmologie, Agaplesion Diakonie Kliniken Kassel, Kassel; 14Medizinische Klinik II - Kardiologie, Klinikum Rheine, Rheine; 15Medizinische Klinik I, Klinikum Osnabrück, Osnabrück; 16Medizinische Klinik II, Krankenhaus Freudenstadt, Freudenstadt; 17Med. Klinik I - Elektrophysiologie, Klinikum Fulda gAG, Fulda; 18Elektrophysiologie/ Rhythmologie, Herz- und Diabeteszentrum NRW, Bad Oeynhausen; 19Medizinische Klinik & Kardio-Diabetes-Zentrum Köln, St. Antonius Krankenhaus, Köln;

Objectives: To determine the 12-months efficacy of pulmonary vein isolation (PVI) using cryoballoon ablation (CBA) performed at community hospitals with limited annual case numbers.


Background: PVI using CBA has become an established procedure for treatment of symptomatic paroxysmal and persistent atrial fibrillation (AF). While the acute safety and procedural efficacy of CBA PVI performed at community hospitals has been reported previously, the 12-month follow-up (F/U) efficacy is unknown.  


Methods: This registry study included 932 consecutive patients (pts) who had PVI performed for symptomatic paroxysmal (n=513; 55%) or persistent AF (n=419; 45%) from January 2019–September 2020 at 18 hospitals, each of which performed fewer than 100 CBA-PVI procedures per year. 40 procedures were re-do PVI. All CBA procedures were performed according to local standards. Frequency of recurrent AF, occurrence of atrial flutter or atrial tachycardia, use of antiarrhythmic drugs, electrical/ pharmacologic cardioversion, and repeat ablation following a 90-day period after the index ablation and up to 12-months were determined. The primary endpoint was the combination of all.


Results: Complete isolation of all pulmonary veins was documented in 98% of pts at the end of the procedure. 12-months F/U data could be obtained in 878 pts (94%). 250 pts (28.5%) complained of recurrent palpitations, in 177 of them (71%) AF was documented. A 24 hour ECG registration was performed in 602 pts (69%). In 94 pts of them (16%) recurrent AF was documented. The primary endpoint was met in 294 F/U pts (33.5%). It consisted of documented AF in 181 patients (20.6%), re-do PVI in 69 pts (7.9%), atrial flutter ablation in 12 pts (1.4%), antiarrhythmic medication in 184 pts (21.0%). The primary endpoint occurred in 146 F/U pts with paroxysmal AF (29.9%), and in 148 F/U pts with persistent AF (37.9%). Out of the 39 F/U pts with an inital re-do PVI the primary endpoint was met in 16 pts (41%). 3 patients had persistent complications of the procedure at 12 months F/U (2 phrenic nerve palsys, 1 hoarseness after transesophageal echocardiography)


Conclusions: PVI procedures for paroxysmal or persistent AF using CBA can be performed at community hospitals with adequate 12-months freedom of recurrent AF.  
https://dgk.org/kongress_programme/jt2022/aP1518.html