RESUMEN
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and its prevalence increases with advancing age. Pulmonary vein isolation is a standard approach in drug refractory paroxysmal AF which could be performed by cryoballoon ablation (CBA). We tried to evaluate its efficacy and safety in Iranian patients with AF. METHODS: From 2015 to 2017, 97 patients with paroxysmal and persistent AF were enrolled in our observational historical cohort study. They were visited 1 and 6 months post-procedure in order to assess the efficacy (recurrence) and safety. Recurrence was defined as 30 seconds of arrhythmia on their 48-hours Holter monitoring. RESULTS: Ninety-seven patients enrolled in the study, 64 (66.0%) of them were men, and their mean age was 55 ± 12 years. Hypertension was reported in 41 patients (42.3%), as the most common cardiac risk factor. 71 patients (73.2%) patients with paroxysmal AF and 15 patients (15.5%) with persistent AF underwent the procedure. After 6 months, recurrence was documented in only 17 patients (17.5%), and 82.5% of the patients were free from the recurrence. Post-procedural complication was detected only in 3 patients (3.1%). CONCLUSION: In our study, the mid-term success and safety of CBA in patients with paroxysmal AF was showed. CBA is a safe and effective method in paroxysmal AF, and even in some cases with persistent AF.
RESUMEN
The aim of this study was to evaluate differences in the electrophysiological features of atrioventricular reentrant tachycardia (AVRT) in patients with Wolf-Parkinson-White syndrome (WPW) associated with or without atrial fibrillation (AF). We included 119 patients with WPW and orthodromic AVRT during electrophysiological study. The patients were divided into two groups; group I with documented episodes of AF (n=39, mean age 33.3+/-11.5 years), and group II without AF (n=80, mean age 35.3+/-13.8). We compared parameters of accessory pathway (AP), atrium and ventricle between two groups and found no significant difference. We next assessed the electrophysiological parameters of AVRT in both groups in terms of conduction times and atrioventricular (AV) activation relations. A significant negative correlation was found in group II between anterograde and retrograde conduction times measured as AV and VA intervals at the site of the earliest atrial activation (r=-0.43, P<0.0001), whereas no significant correlation was seen in group I (r=-0.29, P=0.1). Comparative analysis between two groups revealed significant difference in A-V/V-V index (P=0.05). These data suggest the presence of different electrophysiological properties of AP during AVRT in only few respects in patients with AF compared to those without it.