Impact of cryoballoon application abortion due to phrenic nerve injury on reconnection rates: a YETI subgroup analysis
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Impact of cryoballoon application abortion due to phrenic nerve injury on reconnection rates: a YETI subgroup analysis. / Heeger, Christian-H; Popescu, Sorin Ștefan; Sohns, Christian; Pott, Alexander; Metzner, Andreas; Inaba, Osamu; Straube, Florian; Kuniss, Malte; Aryana, Arash; Miyazaki, Shinsuke; Cay, Serkan; Ehrlich, Joachim R; El-Battrawy, Ibrahim; Martinek, Martin; Saguner, Ardan M; Tscholl, Verena; Yalin, Kivanc; Lyan, Evgeny; Su, Wilber; Papiashvili, Giorgi; Botros, Maichel Sobhy Naguib; Gasperetti, Alessio; Proietti, Riccardo; Wissner, Erik; Scherr, Daniel; Kamioka, Masashi; Makimoto, Hisaki; Urushida, Tsuyoshi; Aksu, Tolga; Chun, Julian K R; Aytemir, Kudret; Jędrzejczyk-Patej, Ewa; Kuck, Karl-Heinz; Dahme, Tillman; Steven, Daniel; Sommer, Philipp; Tilz, Roland Richard.
In: EUROPACE, Vol. 25, No. 2, 16.02.2023, p. 374-381.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of cryoballoon application abortion due to phrenic nerve injury on reconnection rates: a YETI subgroup analysis
AU - Heeger, Christian-H
AU - Popescu, Sorin Ștefan
AU - Sohns, Christian
AU - Pott, Alexander
AU - Metzner, Andreas
AU - Inaba, Osamu
AU - Straube, Florian
AU - Kuniss, Malte
AU - Aryana, Arash
AU - Miyazaki, Shinsuke
AU - Cay, Serkan
AU - Ehrlich, Joachim R
AU - El-Battrawy, Ibrahim
AU - Martinek, Martin
AU - Saguner, Ardan M
AU - Tscholl, Verena
AU - Yalin, Kivanc
AU - Lyan, Evgeny
AU - Su, Wilber
AU - Papiashvili, Giorgi
AU - Botros, Maichel Sobhy Naguib
AU - Gasperetti, Alessio
AU - Proietti, Riccardo
AU - Wissner, Erik
AU - Scherr, Daniel
AU - Kamioka, Masashi
AU - Makimoto, Hisaki
AU - Urushida, Tsuyoshi
AU - Aksu, Tolga
AU - Chun, Julian K R
AU - Aytemir, Kudret
AU - Jędrzejczyk-Patej, Ewa
AU - Kuck, Karl-Heinz
AU - Dahme, Tillman
AU - Steven, Daniel
AU - Sommer, Philipp
AU - Tilz, Roland Richard
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/2/16
Y1 - 2023/2/16
N2 - AIMS: Cryoballoon (CB)-based pulmonary vein isolation (PVI) is an effective treatment for atrial fibrillation (AF). The most frequent complication during CB-based PVI is right-sided phrenic nerve injury (PNI) which is leading to premature abortion of the freeze cycle. Here, we analysed reconnection rates after CB-based PVI and PNI in a large-scale population during repeat procedures.METHODS AND RESULTS: In the YETI registry, a total of 17 356 patients underwent CB-based PVI in 33 centres, and 731 (4.2%) patients experienced PNI. A total of 111/731 (15.2%) patients received a repeat procedure for treatment of recurrent AF. In 94/111 (84.7%) patients data on repeat procedures were available. A total of 89/94 (94.7%) index pulmonary veins (PVs) have been isolated during the initial PVI. During repeat procedures, 22 (24.7%) of initially isolated index PVs showed reconnection. The use of a double stop technique did non influence the PV reconnection rate (P = 0.464). The time to PNI was 140.5 ± 45.1 s in patients with persistent PVI and 133.5 ± 53.8 s in patients with reconnection (P = 0.559). No differences were noted between the two populations in terms of CB temperature at the time of PNI (P = 0.362). The only parameter associated with isolation durability was CB temperature after 30 s of freezing. The PV reconnection did not influence the time to AF recurrence.CONCLUSION: In patients with cryoballon application abortion due to PNI, a high rate of persistent PVI rate was found at repeat procedures. Our data may help to identify the optimal dosing protocol in CB-based PVI procedures.CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT03645577?term=YETI&cntry=DE&draw=2&rank=1 ClinicalTrials.gov Identifier: NCT03645577.
AB - AIMS: Cryoballoon (CB)-based pulmonary vein isolation (PVI) is an effective treatment for atrial fibrillation (AF). The most frequent complication during CB-based PVI is right-sided phrenic nerve injury (PNI) which is leading to premature abortion of the freeze cycle. Here, we analysed reconnection rates after CB-based PVI and PNI in a large-scale population during repeat procedures.METHODS AND RESULTS: In the YETI registry, a total of 17 356 patients underwent CB-based PVI in 33 centres, and 731 (4.2%) patients experienced PNI. A total of 111/731 (15.2%) patients received a repeat procedure for treatment of recurrent AF. In 94/111 (84.7%) patients data on repeat procedures were available. A total of 89/94 (94.7%) index pulmonary veins (PVs) have been isolated during the initial PVI. During repeat procedures, 22 (24.7%) of initially isolated index PVs showed reconnection. The use of a double stop technique did non influence the PV reconnection rate (P = 0.464). The time to PNI was 140.5 ± 45.1 s in patients with persistent PVI and 133.5 ± 53.8 s in patients with reconnection (P = 0.559). No differences were noted between the two populations in terms of CB temperature at the time of PNI (P = 0.362). The only parameter associated with isolation durability was CB temperature after 30 s of freezing. The PV reconnection did not influence the time to AF recurrence.CONCLUSION: In patients with cryoballon application abortion due to PNI, a high rate of persistent PVI rate was found at repeat procedures. Our data may help to identify the optimal dosing protocol in CB-based PVI procedures.CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT03645577?term=YETI&cntry=DE&draw=2&rank=1 ClinicalTrials.gov Identifier: NCT03645577.
U2 - 10.1093/europace/euac212
DO - 10.1093/europace/euac212
M3 - SCORING: Journal article
C2 - 36414239
VL - 25
SP - 374
EP - 381
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 2
ER -
