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Long-Term Evolution of Patients Treated for Paroxysmal Atrial Fibrillation with First and Second Generation Cryoballoon Catheter Ablation with a Prospective Protocol Guided by Complete Bidirectional Left Atrium-Pulmonary Veins Disconnection after Adenosine as Main Target end Point to achieved. Seven Years Follow-up of Patients with a rough estimation profile of Low ALARMEc Score. A Single Center Report

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dc.contributor.author Paylos González, Jesús Manuel
dc.contributor.author Morales, Aracelis
dc.contributor.author Azcona, Luis
dc.contributor.author Paradela, Marisol
dc.contributor.author Yagüe, Raquel
dc.contributor.author Gómez Guijarro, Fernando
dc.contributor.author Lacal, Lourdes
dc.contributor.author Ferrero, Clara
dc.contributor.author Rodríguez, Octavio
dc.date.accessioned 2019-03-06T09:11:25Z
dc.date.available 2019-03-06T09:11:25Z
dc.date.issued 2016
dc.identifier.citation Paylos, J. M., Morales, A., Azcona, L., Paradela, M., Yagüe, R., Gómez Guijarro, F., ... & Rodríguez, O. (2016). Long-term evolution of patients treated for paroxysmal atrial fibrillation with first and second generation cryoballoon catheter ablation with a prospective protocol guided by complete bidirectional left atrium-pulmonary veins disconnection after adenosine as main target end point to achieved. Seven years follow-up of patients with a rough estimation profile of low ALARMEc score. A single center report. Journal of Atrial Fibrillation, 8(6), 6-17. https://www.doi.org/ 10.4022/jafib.1400 spa
dc.identifier.issn 1941-6911
dc.identifier.uri http://hdl.handle.net/11268/7821
dc.description.abstract Introduction: Cryoballoon ablation (CB) has proven effective for treating patients with paroxysmal atrial fibrillation (PAF). We analyzed our seven year follow-up of patients, treated for PAF with first (CB1) and second generation (CB2), with demonstration of LA-PV disconnection with bidirectional block (BB) after adenosine (AD). Methods: Since November 2008 to May 2015, 128 patients, 97 male (58±7 years), without heart disease, highly symptomatic, refractory to antiarrhythmic drugs (AAD) were treated, and follow-up (1411 ±727 days). Left atrial size: 37±6 mm. Results: A total of 439 PV were successfully isolated (91.9%). Acute reconduction: 44 PV (9%): 16 after CB; 16 unmasked by AD; 12 extrapulmonary muscular connections (EMC). Main complication was phrenic nerve palsy (PNP): 9 (7 %). On follow-up, 114 patients (89%) remain asymptomatic in sinus rhythm (SR), free of medication. Fourteen patients (11%) had arrhythmia recurrence: 12 male (52±8 years). Early recurrences occurred in 9 male. Late recurrences presented 3 male at 24, 27 and 60 months, and 2 female at 7 and 40 months respectively. All recurrence patients were Redo, and remain in SR without medication during follow-up. Conclusions: CB alone is very effective and safe for the definitive treatment of patients suffering PAF with 72.6% success rate, increasing up to 89.1% when this protocol is applied in a single procedure. After Redo, all population group (100%), remain in sinus rhythm, freedom of arrhythmia, without AAD, in this very long term follow-up. Checking for BB, AD protocol, and ruling out EMC allowed-us to identified 14.8% of patients with underlying substrate for potential arrhythmia recurrence. CB2 applications entail a highest risk of PNP. Patients with a rough estimated profile of low ALARMEc score (≤ 1) have an excellent long term outcome, being this series the largest follow-up described so far, for patients treated for PAF with CB. spa
dc.description.sponsorship Sin financiación spa
dc.language.iso eng spa
dc.rights Attribution-NonCommercial-NoDerivatives 4.0 Internacional *
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/ *
dc.title Long-Term Evolution of Patients Treated for Paroxysmal Atrial Fibrillation with First and Second Generation Cryoballoon Catheter Ablation with a Prospective Protocol Guided by Complete Bidirectional Left Atrium-Pulmonary Veins Disconnection after Adenosine as Main Target end Point to achieved. Seven Years Follow-up of Patients with a rough estimation profile of Low ALARMEc Score. A Single Center Report spa
dc.type article spa
dc.description.impact 0.157 SJR (2016) Q3, 275/366 Cardiology and Cardiovascular Medicine spa
dc.identifier.doi 10.4022/jafib.1400
dc.rights.accessRights openAccess spa
dc.subject.uem Fibrilación auricular spa
dc.subject.uem Terapéutica spa
dc.subject.unesco Enfermedad cardiovascular spa
dc.subject.unesco Tratamiento médico spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa


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Attribution-NonCommercial-NoDerivatives 4.0 Internacional Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 Internacional