A frozen decade: Ten years outcome of atrial fibrillation ablation using a single shot device for pulmonary vein isolation

Abstract Aims Cryoballoon‐guided pulmonary vein isolation (CB‐PVI) for symptomatic atrial fibrillation (AF) has become an established treatment option with encouraging results in terms of safety and efficacy. Data reporting on long‐term data beyond a follow‐up (FU) period of 5 years is scarce. This prospective study aimed to evaluate very long‐term outcome after CB‐PVI for AF. Methods Data from consecutive patients treated with CB‐PVI for symptomatic and drug refractory AF between 2005 and 2012 were analyzed. Patients with a FU of ≥9 years after index CB‐PVI were included. All patients were continuously followed‐up in our outpatient clinic. Arrhythmia recurrence was defined as AF or atrial tachycardia (AT) lasting >30 s beyond a 3‐month blanking period. Results A total of 385 patients (71% male) were included. Mean age was 58 ± 10 years and paroxysmal AF was present in 93% of patients. Mean FU duration was 124 ± 24 months. At the end of the observational period, 73% of all patients were in stable sinus rhythm after a mean of 2 ± 0.8 ablation procedures. Patients with AF/AT recurrence were older (60 ± 8 vs. 57 ± 10 years; p = .019), had a higher CHA 2 DS 2 ‐Vasc Score (2.47 ± 1.46 vs. 1.98 ± 1.50; p = .01) and presented with a larger left atrium (LA)‐diameter (43 ± 5.6 vs. 40 ± 5.1 mm; p = .002). The LA‐diameter was also a significant predictor for AF/AT recurrence after CB‐PVI (odds ratio: 0.939, 95% confidence interval: [0.886, 0.992], p = .03). Conclusions CB‐PVI as index procedure for AF ablation resulted in favorable long‐term outcome in symptomatic AF. CB‐PVI might be recommended as interventional therapy in patients with lower LA remodeling.