PO-711-03 A RANDOMISED COMPARISON OF METHODOLOGY IN CRYOBALLOON ABLATION FOR ATRIAL FIBRILLATION: RESULTS AT UP TO A DECADE

Abstract

A single-centre randomized trial investigated the value of the Achieve mapping catheter in cryoballoon procedures for paroxysmal atrial fibrillation (AF) in 2011-2014. Long-term outcomes from the cohort were determined. To evaluate the predictors of long-term outcome after a cryoballoon ablation for paroxysmal atrial fibrillation. Study patients were randomly assigned to Achieve versus Lasso guided cryoballoon ablation. Patient and study procedure characteristics and clinical outcomes were determined, including AF recurrence, repeat ablations and characteristics and death. Of 102 patients in the original study, 98 had long-term (4.11+/-2.82 years) follow up data available. 35 patients (35.7%) had AF recurrence, giving a long-term success rate at 64.3% after 1 ablation, increasing to 81.6% after repeat ablation. n=8 (8.16%) of the study cohort died at a median of 4.9 years after ablation (IQR:1.7-5.7). 25/98 (25.5%) patients had a second ablation and 7 (7.1%) had subsequent ablation. Those who had AF recurrence were older, with a prior history of ischaemic heart disease and cardiac device implantation (p=0.02-0.03). After multi-variate analysis, a prior implanted cardiac device was the only significant predictor of recurrence (p=0.03). Long-term outcomes after a 1st time PAF cryoablation were similar regardless of generation of cryoballoon, type of mapping catheter used and traditional procedure endpoints. AF recurrences were more likely to occur in older patients with a history of ischaemic heart disease and implanted cardiac devices.