Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational Project

Background. The real-world efficacy and safety of atrial fibrillation (AF) ablation in particularly young and elderly patients are still under debate. The aim of the analysis was to investigate the effect of age on the efficacy and safety of cryoballoon ablation (CBA). Methods. 2,534 patients underw...

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Main Authors: Luigi Sciarra, Saverio Iacopino, Giuseppe Arena, Claudio Tondo, Paolo Pieragnoli, Giulio Molon, Massimiliano Manfrin, Antonio Curnis, Antonio Dello Russo, Giovanni Rovaris, Giuseppe Stabile, Leonardo Calò, Gabriele Boscolo, Roberto Verlato
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2021/9996047
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author Luigi Sciarra
Saverio Iacopino
Giuseppe Arena
Claudio Tondo
Paolo Pieragnoli
Giulio Molon
Massimiliano Manfrin
Antonio Curnis
Antonio Dello Russo
Giovanni Rovaris
Giuseppe Stabile
Leonardo Calò
Gabriele Boscolo
Roberto Verlato
author_facet Luigi Sciarra
Saverio Iacopino
Giuseppe Arena
Claudio Tondo
Paolo Pieragnoli
Giulio Molon
Massimiliano Manfrin
Antonio Curnis
Antonio Dello Russo
Giovanni Rovaris
Giuseppe Stabile
Leonardo Calò
Gabriele Boscolo
Roberto Verlato
author_sort Luigi Sciarra
collection DOAJ
description Background. The real-world efficacy and safety of atrial fibrillation (AF) ablation in particularly young and elderly patients are still under debate. The aim of the analysis was to investigate the effect of age on the efficacy and safety of cryoballoon ablation (CBA). Methods. 2,534 patients underwent pulmonary vein isolation (PVI) by way of CBA for paroxysmal or persistent drug-resistant and symptomatic AF. The population was divided into age quartiles for evaluation, including (1) <53 years, (2) ≥53 and <61 years, (3) ≥61 and <67 years, and (4) ≥67 years. Furthermore, outcomes were analyzed in patients <41 years, ≥41 and ≤74, and >74 years old. Procedural data and complications were collected, and atrial fibrillation recurrences were evaluated during follow-up. Results. Procedural-related complications (4.1%) were similar in the four subgroups according to age. At the 12-month follow-up, freedom from AF recurrence was 79.2%, 77.4%, 76.8%, and 75.2% (p=0.21), respectively (with increasing age). At 24-month follow-up, similar incidences of AF recurrence were observed in the four subgroups. When the sample was arbitrarily divided into the three age groups, a higher rate of recurrence was observed in older patients with regard to long-term follow-up (freedom from AF recurrence was 71.8% and 40.9%, respectively, at 12 and 24-month follow-up). In the univariate and multivariate analysis, age did not result in a significant predictor of AF recurrence during follow-up; however, a trend toward higher AF recurrences rates in patients ≥67 years was observed. Conclusion. The data demonstrated a high degree of safety during CBA across all patient ages. Procedural performance and complications were similar between different ages; AF recurrences seem to be more frequent in patients over 74 years.
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spelling doaj-art-771601269424498e933f1be35c8649872025-02-03T06:44:14ZengWileyCardiology Research and Practice2090-05972021-01-01202110.1155/2021/9996047Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational ProjectLuigi Sciarra0Saverio Iacopino1Giuseppe Arena2Claudio Tondo3Paolo Pieragnoli4Giulio Molon5Massimiliano Manfrin6Antonio Curnis7Antonio Dello Russo8Giovanni Rovaris9Giuseppe Stabile10Leonardo Calò11Gabriele Boscolo12Roberto Verlato13Cardiology DepartmentMaria Cecilia HospitalNuovo Ospedale Delle ApuaneHeart Rhythm Center at Monzino Cardiac CenterCareggi HospitalIRCCS Sacro Cuore Don Calabria HospitalOspedale Centrale di BolzanoSpedali CiviliCardiology and Arrhythmology ClinicOspedale San GerardoClinica Montevergine Mercogliano (AV)Cardiology DepartmentAzienda ULSS 3 Ospedale di ChioggiaULSS 6 EuganeaBackground. The real-world efficacy and safety of atrial fibrillation (AF) ablation in particularly young and elderly patients are still under debate. The aim of the analysis was to investigate the effect of age on the efficacy and safety of cryoballoon ablation (CBA). Methods. 2,534 patients underwent pulmonary vein isolation (PVI) by way of CBA for paroxysmal or persistent drug-resistant and symptomatic AF. The population was divided into age quartiles for evaluation, including (1) <53 years, (2) ≥53 and <61 years, (3) ≥61 and <67 years, and (4) ≥67 years. Furthermore, outcomes were analyzed in patients <41 years, ≥41 and ≤74, and >74 years old. Procedural data and complications were collected, and atrial fibrillation recurrences were evaluated during follow-up. Results. Procedural-related complications (4.1%) were similar in the four subgroups according to age. At the 12-month follow-up, freedom from AF recurrence was 79.2%, 77.4%, 76.8%, and 75.2% (p=0.21), respectively (with increasing age). At 24-month follow-up, similar incidences of AF recurrence were observed in the four subgroups. When the sample was arbitrarily divided into the three age groups, a higher rate of recurrence was observed in older patients with regard to long-term follow-up (freedom from AF recurrence was 71.8% and 40.9%, respectively, at 12 and 24-month follow-up). In the univariate and multivariate analysis, age did not result in a significant predictor of AF recurrence during follow-up; however, a trend toward higher AF recurrences rates in patients ≥67 years was observed. Conclusion. The data demonstrated a high degree of safety during CBA across all patient ages. Procedural performance and complications were similar between different ages; AF recurrences seem to be more frequent in patients over 74 years.http://dx.doi.org/10.1155/2021/9996047
spellingShingle Luigi Sciarra
Saverio Iacopino
Giuseppe Arena
Claudio Tondo
Paolo Pieragnoli
Giulio Molon
Massimiliano Manfrin
Antonio Curnis
Antonio Dello Russo
Giovanni Rovaris
Giuseppe Stabile
Leonardo Calò
Gabriele Boscolo
Roberto Verlato
Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational Project
Cardiology Research and Practice
title Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational Project
title_full Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational Project
title_fullStr Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational Project
title_full_unstemmed Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational Project
title_short Safety and Efficacy of Cryoballoon Ablation of Atrial Fibrillation in relation to the Patients’ Age: Results from a Large Real-World Multicenter Observational Project
title_sort safety and efficacy of cryoballoon ablation of atrial fibrillation in relation to the patients age results from a large real world multicenter observational project
url http://dx.doi.org/10.1155/2021/9996047
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