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OP-105 Variations in Pulmonary Vein Anatomy Predict Outcome Following Pulmonary Vein Isolation Using Cryoballoon
MARCH 26e29, 2015
Cryoballoon Based Ablation in Atrial Fibrillation: Effectiveness and Outcomes Saturday, March 28, 2015 10:30 AM w 12:00 AM, Hall 8 (Abstract nos. OP-105 w OP-112) - OP-105 Variations in Pulmonary Vein Anatomy Predict Outcome Following Pulmonary Vein Isolation Using Cryoballoon. Muhammed Ulvi Yalcin1, Kadri Murat Gurses2, Duygu Kocyigit2, Gamze Turk3, Banu Evranos2, Hikmet Yorgun2, Mehmet Levent Sahiner2, Ergun Baris Kaya2, Tuncay Hazirolan3, Mehmet Ali Oto2, Kudret Aytemir2, Necla Ozer2. 1Department of Cardiology, Hakkari State Hospital, Hakkari Turkey; 2Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara Turkey; 3Department of Radiology, Hacettepe University Faculty of Medicine, Ankara Turkey. Objectives: Association between focal pulmonary vein (PV) potentials and atrial fibrillation (AF) has made circumferential PV isolation (PVI) using cryoballoon system the cornerstone of AF treatment. AF recurrence is mostly due to PV reconnection; however, data on the relationship between PV anatomy and AF recurrence following PVI with cryoballoon is lacking. Our study aims to assess the impact of PV anatomy on outcome after AF ablation. Methods: 249 patients with AF who were scheduled for PVI with cryoballoon underwent computed tomography and PV anatomy was assessed via three- dimensional reconstructions. Results: 85 patients (34.1%) had left common PV, where only 4 patients (1.6%) had right common PV. At a mean follow-up of 29 (348) months, 184 (73.9%) patients were free of AF. In multivariate survival analysis using Cox’s regression model; left superior PV area (LSPVA), right inferior PV area (RIPVA) and early AF recurrence within first 3 months were found to be independent predictors of late AF recurrence. Conclusion: LSPVA, RIPVA and early AF recurrence are independent predictors of AF recurrence following PVI with cryoballoon. Differences in PV anatomy may partly explain the variety in outcomes following circumferential PV isolation in AF patients.
- OP-106 Elevated Left Ventricular Diastolic Pressure Estimated by E/e’ Ratio Predicts Outcome in Paroxysmal Atrial Fibrillation Patients Undergoing Pulmonary Vein Isolation with Second-generation Cryoballoon. Kadri Murat Gurses1, Muhammed Ulvi Yalcin2, Duygu Kocyigit1, Banu Evranos1, Hikmet Yorgun1, Mehmet Levent Sahiner1, Ergun Baris Kaya1, Mehmet Ali Oto1, Necla Ozer1, Kudret Aytemir1. 1Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara Turkey; 2 Department of Cardiology, Hakkari State Hospital, Hakkari Turkey. Objectives: Previous studies have shown that left ventricular diastolic dysfunction (LVDD) contribute to atrial fibrillation (AF) pathogenesis.
However, data on the impact of LVDD on AF recurrence after cryoballoon-based pulmonary ven isolation (PVI) is limited. In this study, we aimed to determine the predictive value of pre-procedural parameters of left ventricular diastolic function for late AF recurrence in AF patients following PVI with second- generation cryoballoon. Methods: Paroxysmal AF patients who were scheduled to undergo cryoballoon-based PVI were enrolled in the study. Each patient underwent transthoracic echocardiography, and LVDD was determined by left atrial volume index (LAVI), transmitral and tissue Doppler parameters. Patients were followed- up for 12 months. Results: 77 patients (55.9 12.2 years, 55.8 % female) were included. Late AF recurrence occurred in 8 (10.4%) patients. In the Cox regression model, only E/e’ ratio (HR: 1.42, 95% CI: 1.06- 1.89, p¼0.018) and LAVI (HR: 1.38, 95% CI: 1.03- 1.85, p¼0.033) were found to be independent predictors of late AF recurrence. Receiver operating characteristic analysis has shown that a cut- off value of 12.1 for E/e’ ratio predicted late AF recurrence with a sensitivity and specificity of 87.5% and 84.1%, respectively (p<0.001). Conclusion: E/e’ ratio is an independent predictor of late AF recurrence following PVI with second- generation cryoballoon in paroxysmal AF patients. As an indicator of increased left ventricular diastolic pressure, E/e’ ratio may serve as a non- invasive marker for predicting post- ablation AF recurrence.
Figure.
- OP-107 Radiofrequency Ablation Versus Cryoballoon Ablation for Pulmonary Vein Isolation: A Meta-Analysis of Randomized Studies. Serkan Cay, Ozcan Ozeke, Firat Ozcan, Dursun Aras, Serkan Topaloglu, Ugur Canpolat, Hande Cetin, Baris Sensoy, Cagri Yayla, Orkun Temizer, Erol Kalender. Department of Cardiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey. Aim: The aim of the current meta-analysis was to compare the efficacy between radiofrequency and cryoballoon ablations by analyzing published randomized clinical studies. Methods: Published studies were extracted from the MEDLINE until December 2014. A total of 229 patients, 120 for radiofrequency ablation and 109 for cryoballoon ablation, from 3 randomized trials were included in the meta-analysis.
The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S47
O R A L A B S T R A C T S
Cryoballoon Based Ablation in Atrial Fibrillation: Effectiveness and Outcomes Saturday, March 28, 2015 10:30 AM w 12:00 AM, Hall 8 (Abstract nos. OP-105 w OP-112) - OP-105 Variations in Pulmonary Vein Anatomy Predict Outcome Following Pulmonary Vein Isolation Using Cryoballoon. Muhammed Ulvi Yalcin1, Kadri Murat Gurses2, Duygu Kocyigit2, Gamze Turk3, Banu Evranos2, Hikmet Yorgun2, Mehmet Levent Sahiner2, Ergun Baris Kaya2, Tuncay Hazirolan3, Mehmet Ali Oto2, Kudret Aytemir2, Necla Ozer2. 1Department of Cardiology, Hakkari State Hospital, Hakkari Turkey; 2Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara Turkey; 3Department of Radiology, Hacettepe University Faculty of Medicine, Ankara Turkey. Objectives: Association between focal pulmonary vein (PV) potentials and atrial fibrillation (AF) has made circumferential PV isolation (PVI) using cryoballoon system the cornerstone of AF treatment. AF recurrence is mostly due to PV reconnection; however, data on the relationship between PV anatomy and AF recurrence following PVI with cryoballoon is lacking. Our study aims to assess the impact of PV anatomy on outcome after AF ablation. Methods: 249 patients with AF who were scheduled for PVI with cryoballoon underwent computed tomography and PV anatomy was assessed via three- dimensional reconstructions. Results: 85 patients (34.1%) had left common PV, where only 4 patients (1.6%) had right common PV. At a mean follow-up of 29 (348) months, 184 (73.9%) patients were free of AF. In multivariate survival analysis using Cox’s regression model; left superior PV area (LSPVA), right inferior PV area (RIPVA) and early AF recurrence within first 3 months were found to be independent predictors of late AF recurrence. Conclusion: LSPVA, RIPVA and early AF recurrence are independent predictors of AF recurrence following PVI with cryoballoon. Differences in PV anatomy may partly explain the variety in outcomes following circumferential PV isolation in AF patients.
- OP-106 Elevated Left Ventricular Diastolic Pressure Estimated by E/e’ Ratio Predicts Outcome in Paroxysmal Atrial Fibrillation Patients Undergoing Pulmonary Vein Isolation with Second-generation Cryoballoon. Kadri Murat Gurses1, Muhammed Ulvi Yalcin2, Duygu Kocyigit1, Banu Evranos1, Hikmet Yorgun1, Mehmet Levent Sahiner1, Ergun Baris Kaya1, Mehmet Ali Oto1, Necla Ozer1, Kudret Aytemir1. 1Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara Turkey; 2 Department of Cardiology, Hakkari State Hospital, Hakkari Turkey. Objectives: Previous studies have shown that left ventricular diastolic dysfunction (LVDD) contribute to atrial fibrillation (AF) pathogenesis.
However, data on the impact of LVDD on AF recurrence after cryoballoon-based pulmonary ven isolation (PVI) is limited. In this study, we aimed to determine the predictive value of pre-procedural parameters of left ventricular diastolic function for late AF recurrence in AF patients following PVI with second- generation cryoballoon. Methods: Paroxysmal AF patients who were scheduled to undergo cryoballoon-based PVI were enrolled in the study. Each patient underwent transthoracic echocardiography, and LVDD was determined by left atrial volume index (LAVI), transmitral and tissue Doppler parameters. Patients were followed- up for 12 months. Results: 77 patients (55.9 12.2 years, 55.8 % female) were included. Late AF recurrence occurred in 8 (10.4%) patients. In the Cox regression model, only E/e’ ratio (HR: 1.42, 95% CI: 1.06- 1.89, p¼0.018) and LAVI (HR: 1.38, 95% CI: 1.03- 1.85, p¼0.033) were found to be independent predictors of late AF recurrence. Receiver operating characteristic analysis has shown that a cut- off value of 12.1 for E/e’ ratio predicted late AF recurrence with a sensitivity and specificity of 87.5% and 84.1%, respectively (p<0.001). Conclusion: E/e’ ratio is an independent predictor of late AF recurrence following PVI with second- generation cryoballoon in paroxysmal AF patients. As an indicator of increased left ventricular diastolic pressure, E/e’ ratio may serve as a non- invasive marker for predicting post- ablation AF recurrence.
Figure.
- OP-107 Radiofrequency Ablation Versus Cryoballoon Ablation for Pulmonary Vein Isolation: A Meta-Analysis of Randomized Studies. Serkan Cay, Ozcan Ozeke, Firat Ozcan, Dursun Aras, Serkan Topaloglu, Ugur Canpolat, Hande Cetin, Baris Sensoy, Cagri Yayla, Orkun Temizer, Erol Kalender. Department of Cardiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey. Aim: The aim of the current meta-analysis was to compare the efficacy between radiofrequency and cryoballoon ablations by analyzing published randomized clinical studies. Methods: Published studies were extracted from the MEDLINE until December 2014. A total of 229 patients, 120 for radiofrequency ablation and 109 for cryoballoon ablation, from 3 randomized trials were included in the meta-analysis.
The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
S47
O R A L A B S T R A C T S