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Outcomes of atrial fibrillation ablation program based on single-shot techniques
Marek Jastrzębski1, Grzegorz Kiełbasa1, Kamil Fijorek2
1First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland.
Summary
Sequential use of single-shot atrial fibrillation (AF) ablation techniques, including cryoballoon and PVAC, is safe and effective for both initial and repeat procedures. This strategy offers a viable alternative for AF ablation programs, especially for new operators.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Atrial fibrillation (AF) ablation commonly uses point-by-point radiofrequency, but single-shot techniques like cryoballoon and PVAC offer alternatives.
- Limited data exists on the sequential application of different single-shot techniques for both initial (index) and repeat (redo) AF ablation procedures.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of an AF ablation strategy exclusively using single-shot techniques for both index and redo procedures.
Main Methods:
- A 10-year retrospective analysis (2009-2019) of consecutive AF ablations performed under a 'single-shot technique only' protocol.
- Kaplan-Meier analysis was used to determine AF-free survival rates.
- Complications were prospectively recorded and assessed.
Main Results:
- 597 patients underwent 655 AF ablation procedures; 78.1% had paroxysmal AF, 21.9% persistent AF.
- In 96.5% of redo procedures (n=58), a different single-shot technique (primarily PVAC) was used compared to the index ablation (primarily cryoballoon).
- Five-year AF-free survival was 56.0% for index ablation and 68.3% for redo procedures. Minor and major complication rates were 8.1% and 4.0%, respectively.
Conclusions:
- An AF ablation program utilizing sequential single-shot techniques for both index and redo procedures demonstrates safety and effectiveness.
- This approach has significant practical implications for new centers initiating AF ablation and for optimizing redo procedures using single-shot methods.
