Safety and long-term efficacy of cryoballoon ablation for atrial fibrillation in octogenarians: a multicenter experience

• DOI: 10.1007/s10840-022-01313-x
• Publication Date: 2022-07-22T18:04:49Z
• Authors: Federico Cecchini; Giacomo Mugnai; Saverio Iacopino; Juan Pablo Abugattas; Bert Adriaenssens; Maysam Al-Housari; Alexandre Almorad; Gezim Bala; Antonio Bisignani; Carlo de Asmundis; Yves De Greef; Riccardo Maj; Thiago G. Osòrio; Luigi Pannone; Bruno Schwagten; Juan Sieira; Antonio Sorgente; Erwin Stroker; Michael Wolf; Gian-Battista Chi...
• Keywords: Cryoablation; Single Center; Atrial tachycardia

Cryoballoon technology (CB-A) has become a cornerstone of atrial fibrillation (AF) ablation in terms of safety and efficacy. Data regarding CB-A in octogenarians are still scarce and limited to single center experiences. The present study sought to analyze the performances of index CB-A in patients older than 80 years-old referring to 3 high-volume European centers.We retrospectively enrolled 95 patients with a median age of 81 [80, 83] years. 62 (65.3%) patients presented with paroxysmal AF and 33 (33.7%) with persistent AF. Mean procedure and fluoroscopy times were 73.8 ± 25.2 and 15.3 ± 7.5 min, respectively. At 12 months and 24 months of follow-up, the overall freedom from AF was 81.1% and 66.6%, respectively. When divided for AF type, freedom from AF was higher in patients with paroxysmal AF (p = 0.007). Cryoballoon ablation was able to significantly improve AF-related symptoms as proven by the significant decrease in EHRA score during the follow-up (p < 0.0001). Phrenic nerve palsy occurred in 8 (8.5%) patients and always resolved during the procedure without affecting procedural outcome. Two major complications occurred (2.1%); one patient experienced pneumonia, successfully treated with antibiotics and non-invasive mechanical ventilation, the latter one experienced acute kidney failure secondary to urosepsis successfully treated by renal replacement therapy.The present study showed that CB-A is a feasible and effective procedure among octogenarians with a low complication rate. Contemporarily, CB-A can help to alleviate arrhythmia-related symptoms also among this group of subjects.