Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a "bonus-freeze" and "no bonus-freeze" protocol using the second-generation cryoballoon for pulmonary vein isolation
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Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a "bonus-freeze" and "no bonus-freeze" protocol using the second-generation cryoballoon for pulmonary vein isolation. / Heeger, Christian-H; Wissner, Erik; Wohlmuth, Peter; Mathew, Shibu; Hayashi, Kentaro; Sohns, Christian; Reißmann, Bruno; Lemes, Christine; Maurer, Tilman; Saguner, Ardan M; Santoro, Francesco; Riedl, Johannes; Ouyang, Feifan; Kuck, Karl-Heinz; Metzner, Andreas.
in: CLIN RES CARDIOL, Jahrgang 105, Nr. 9, 09.2016, S. 774-82.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a "bonus-freeze" and "no bonus-freeze" protocol using the second-generation cryoballoon for pulmonary vein isolation
AU - Heeger, Christian-H
AU - Wissner, Erik
AU - Wohlmuth, Peter
AU - Mathew, Shibu
AU - Hayashi, Kentaro
AU - Sohns, Christian
AU - Reißmann, Bruno
AU - Lemes, Christine
AU - Maurer, Tilman
AU - Saguner, Ardan M
AU - Santoro, Francesco
AU - Riedl, Johannes
AU - Ouyang, Feifan
AU - Kuck, Karl-Heinz
AU - Metzner, Andreas
PY - 2016/9
Y1 - 2016/9
N2 - BACKGROUND: Second-generation cryoballoon based pulmonary vein isolation has demonstrated encouraging acute and mid-term clinical outcome. Customarily, a bonus-freeze is applied after successful pulmonary vein isolation.OBJECTIVE: To compare the long-term clinical outcome and safety profile of a bonus-freeze and a no bonus-freeze protocol.METHODS: A total of 120 consecutive patients with paroxysmal [95/120 (79 %)] or persistent atrial fibrillation [25/120 (21 %)] underwent CB2-based PVI. Freeze-cycle duration was 240 s. In the first 60 patients a bonus-freeze was applied after successful PVI (group 1), while in the following 60 patients the bonus-freeze was omitted (group 2).RESULTS: Procedure and fluoroscopy times were significantly shorter in group 2 [113.8 ± 32 vs 138.2 ± 29 min (p = 0.03) and 19.2 ± 6 vs 24.3 ± 8 min (p = 0.02)]. No differences in procedural complications were found. During a mean follow-up of 849 ± 74 (group 1) and 848 ± 101 days (group 2, p = 0.13) 69 % of patients (group 1) and 67 % of patients (group 2) remained in stable sinus rhythm without any differences between the groups (p = 0.69).CONCLUSIONS: Freedom from atrial fibrillation after second-generation cryoballoon based pulmonary vein isolation and a follow-up of >2 years is comparable when applying a bonus- and a no bonus-freeze protocol, while procedure and fluoroscopy times are significantly shorter when omitting the bonus-freeze. No differences in periprocedural complications were identified.
AB - BACKGROUND: Second-generation cryoballoon based pulmonary vein isolation has demonstrated encouraging acute and mid-term clinical outcome. Customarily, a bonus-freeze is applied after successful pulmonary vein isolation.OBJECTIVE: To compare the long-term clinical outcome and safety profile of a bonus-freeze and a no bonus-freeze protocol.METHODS: A total of 120 consecutive patients with paroxysmal [95/120 (79 %)] or persistent atrial fibrillation [25/120 (21 %)] underwent CB2-based PVI. Freeze-cycle duration was 240 s. In the first 60 patients a bonus-freeze was applied after successful PVI (group 1), while in the following 60 patients the bonus-freeze was omitted (group 2).RESULTS: Procedure and fluoroscopy times were significantly shorter in group 2 [113.8 ± 32 vs 138.2 ± 29 min (p = 0.03) and 19.2 ± 6 vs 24.3 ± 8 min (p = 0.02)]. No differences in procedural complications were found. During a mean follow-up of 849 ± 74 (group 1) and 848 ± 101 days (group 2, p = 0.13) 69 % of patients (group 1) and 67 % of patients (group 2) remained in stable sinus rhythm without any differences between the groups (p = 0.69).CONCLUSIONS: Freedom from atrial fibrillation after second-generation cryoballoon based pulmonary vein isolation and a follow-up of >2 years is comparable when applying a bonus- and a no bonus-freeze protocol, while procedure and fluoroscopy times are significantly shorter when omitting the bonus-freeze. No differences in periprocedural complications were identified.
KW - Aged
KW - Atrial Fibrillation/diagnostic imaging
KW - Cardiac Catheters
KW - Cryosurgery/adverse effects
KW - Electrocardiography, Ambulatory
KW - Equipment Design
KW - Female
KW - Fluoroscopy
KW - Humans
KW - Male
KW - Middle Aged
KW - Pulmonary Veins/diagnostic imaging
KW - Radiation Dosage
KW - Radiation Exposure
KW - Radiography, Interventional/methods
KW - Retrospective Studies
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1007/s00392-016-0987-8
DO - 10.1007/s00392-016-0987-8
M3 - SCORING: Journal article
C2 - 27085722
VL - 105
SP - 774
EP - 782
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 9
ER -