B-PO03-100 CARDIAC ENZYME ELEVATION AND SHORT TERM CLINICAL OUTCOME AFTER CRYOBALLOON ABLATION OF LEFT ATRIAL POSTERIOR WALL FOR PERSISTENT ATRIAL FIBRILLATION

Abstract

The effectiveness of left atrial posterior wall (LAPW) ablation using cryoballoon (CB) ablation was not sufficiently evaluated. We aim to compare the degree of myocardial injury and early clinical outcome of LAPW or roof line using CB ablation to those using RFCA (radiofrequency catheter ablation). A total of 100 patients with persistent atrial fibrillation (AF) (66.7% long standing persistent AF, 49 CB and 51 RFCA) were enrolled from 2017 to 2020. Patients underwent pulmonary vein isolation (PVI) with LAPW using CB or RFCA. Acute successful ablation of LAPW was defined as complete elimination of local electrical activities in LAPW. The completeness of roof line was assessed by bidirectional conduction block by differential pacing. The main outcomes were level of cardiac enzyme (troponin-I) elevation after procedure and early recurrence of atrial fibrillation or flutter. Acute successful ablation of LAPW or roof line was achieved in 64.5% of RFCA group and 69.4% of CB group (P=0.698). Total procedure time (CB 145.6 ± 54.5 min vs. RF 184.0 ± 62.1 min, P=0.003) and ablation time (CB 2324.5 ± 660.2 min vs. RF 2855.3 ± 1101.3 min, P=0.005) was shorter in CB group. Troponin-I at one day after the procedure was more elevated in CB group compared with RFCA group (CB 11.6 ± 6.8 ng/mL vs. RFCA 5.0 ± 3.8 ng/mL, p<0.001). Rate of freedom from atrial tachyarrhythmia (AF for atrial flutter) at 3months were comparable between 2 groups (CB 59.2% vs. RFCA 66.7%, P=0.57). In patients with persistent AF who underwent PVI and LAPW ablation or roof line ablation, cardiac enzyme elevation is more prominent and short term clinical outcome is comparable in CB ablation group compared with RFCA group.