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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1522086
Instant termination as a novel indicator for prognosis of persistent atrial fibrillation during cryoballoon ablation: A propensity score matched analysis
Provisionally accepted- Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
Background: Instant termination of atrial fibrillation (AF) (AFT) during radiofrequency ablation has been suggested as a predictor of prognosis in persistent AF. However, its role in cryoballoon ablation remains unclear. This study investigated the association between AFT and recurrent atrial tachyarrhythmia in patients with persistent AF undergoing cryoballoon ablation. Methods: Patients with non-valvular, drug-resistant, persistent AF who underwent cryoballoon ablation between Jan. 2021 and Jun. 2023 were included and categorized based on the presence or absence of AFT. Propensity score matching (PSM) was applied to eliminate covariate imbalances. Baseline characteristics, procedural details, and clinical outcomes were compared between the groups. Results: A total of 189 patients (65.0 [59.0-71.0] years) were included. 41 patients experienced instant AFT and 148 remained in AF rhythm. The baseline conditions were similar, except that patients with AFT presented significantly lower left atrial diameter (LAD). During a follow-up of 16.0 [9.1-26.9] months, the recurrence rates of arrhythmias was significantly lower in AFT group (Log-rank P=0.044). Both AFT (HR 0.298, 95% CI [0.091-0.976], P=0.035) and baseline LAD (HR 1.079, 95%CI [1.012-1.151], P=0.021) were independent predictors of recurrence. We further assessed the prognostic value of AFT in PSM-matched groups which showed that the recurrence rates were also significantly lower in AFT group (Log-rank P=0.049). Conclusion: Instant AFT during cryoballoon ablation is associated with a reduced risk of arrhythmic recurrence in patients with persistent AF.
Keywords: instant termination of atrial fibrillation1, cryoballoon ablation2, Left atrial diameter3, arrhythmic recurrence4, persistent atrial fibrillation5
Received: 03 Nov 2024; Accepted: 11 Feb 2025.
Copyright: © 2025 Fan, Ye, Wang, song, Zhang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Youqi Fan, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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