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Russian registry of cryoballon ablation of atrial fibrillation: characteristics of the procedure and features of patient’s management

https://doi.org/10.35336/VA-1447

EDN: ATOKGO

Abstract

Aim. To study the characteristics of the atrial fibrillation (AF) cryoballoon ablation (CBA) procedure and features of patient’s management in real clinical practice in Russia.

Methods. “Prospective Atrial Fibrillation Cryoablation Registry” is an observational prospective national multicenter study. It was conducted from 01.2017 to 12.2019 in centers of Russian Federation. The registry included patients over the age of 18 who were agreed to participate this study and had indications for CBA of AF. The study protocol did not provide for significant restrictions on inclusion criteria, procedure technique and postoperative follow-up. The data was collected prior to the CBA of AF, during hospitalization for CBA and on the 12-month follow-up.

Results. Participating centers enroll 980 patients according to inclusion criteria. CBA of AF was performed in 976 (99.6%) (mean age 59.7±9.2 years, 545 (55.8%) men) primary procedure - 840 (86.1%), re-ablation - 136 (13.9%). Parox- ysmal AF occurred in 828 (84.8%) patients and persistent AF (mean time of persistence 4.4±3.7 months) - in 145 (15.1%) patients. The average procedure time was 108.1±33.3 minutes and mean fluoroscopy time was 24.9±13.6 min. Most of the procedures were performed under general anesthesia. Complications after AF CBA occurred in 53 (5.4%) patients. The most common complication was paresis of the phrenic nerve - 20 (37.7%) cases which were associated with lower temperatures of CBA application of the right pulmonary veins (τ=0.08; p<0.05). The features of antiarrhythmic and anticoagulant therapy were evaluated. A group of patients without adequate anticoagulant therapy in the postoperative period was identified. Due to COVID-19 restrictions only 374 (38.3%) patients completed 12-month follow-up. The recurrence of arrhythmia was occurred in 85 (22.7%) patients. Multivariate regression analysis revealed the following predictors of arrhythmia recurrence: the first procedure (OR 3.96; p=0.023), male sex (OR 1.77; p=0.014), duration of the procedure (min) (OR 1.01; p=0.007).

Conclusion. CBA is an effective and relatively safe procedure for the treatment of paroxysmal and persistent AF. Data from real clinical practice show a low proportion of serious complications of AF CBA. Data on the dynamics of drug therapy, including anticoagulant and antiarrhythmic therapy, were obtained. The attention of specialists performing AF catheter ablation and patient monitoring is required, since errors in patient management have been identified.

About the Authors

L. E. Korobchenko
FSBI “Almazov NMRC” of the MH RF
Russian Federation

Lev E. Korobchenko.

2nd Akkuratova str., Saint Petersburg



T. A. Lyubimtseva
FSBI “Almazov NMRC” of the MH RF
Russian Federation

2nd Akkuratova str., Saint Petersburg



K. V. Davtyan
FSBI “NMRC for Therapy and Preventive Medicine” of the MH RF
Russian Federation

10th Petroverigsky Lane, Moscow



A. G. Topchyan
FSBI “NMRC for Therapy and Preventive Medicine” of the MH RF
Russian Federation

10th Petroverigsky Lane, Moscow



G. Yu. Simonyan
FSBI “NMRC for Therapy and Preventive Medicine” of the MH RF
Russian Federation

10th Petroverigsky Lane, Moscow



S. E. Serduk
FSBI “NMRC for Therapy and Preventive Medicine” of the MH RF
Russian Federation

10th Petroverigsky Lane, Moscow



S. V. Korolev
FSBI “Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the FMBA”
Russian Federation

28th Orekhovy Boulevard



A. Ya. Kosonogov
State budgetary medical centre “City Clinical Hospital N5” of the Nizhny Novgorod district of Nizhny Novgorod
Russian Federation

Nizhny Novgorod, 34th Nesterova str.



K. A. Kosonogov
State budgetary medical centre “City Clinical Hospital N5” of the Nizhny Novgorod district of Nizhny Novgorod
Russian Federation

Nizhny Novgorod, 34th Nesterova str.



E. S. Tarasyuk
Federal state budgetary educational institution of higher education “Amur State Medical Academy” of the MH RF
Russian Federation

Blagoveshchensk, 95th Gorky str.



K. A. Lubenkov
Federal state budgetary educational institution of higher education “Amur State Medical Academy” of the MH RF
Russian Federation

Blagoveshchensk, 95th Gorky str.



A. S. Shulga
Federal state budgetary educational institution of higher education “Amur State Medical Academy” of the MH RF
Russian Federation

Blagoveshchensk, 95th Gorky str.



E. A. Artyukhina
FSBI “Vishnevsky NMRC for Surgery” of the MH RF
Russian Federation

Moscow, 27th Bolshaya Serpukhovskaya str.



A. Sh. Revishvili
FSBI “Vishnevsky NMRC for Surgery” of the MH RF
Russian Federation

Moscow, 27th Bolshaya Serpukhovskaya str.



D. V. Kryzhanovskii
State budgetary medical centre “City Hospital N26” of St. Petersburg
Russian Federation

St. Petersburg, 2nd Kostiusko str.



R. E. Batalov
Scientific Research Institute of Cardiology - branch of the FSBI “Tomsk National Research Medical Center of the RAS”
Russian Federation

Tomsk, 111-A Kievskaya str.



S. Yu. Usenkov
Scientific Research Institute of Cardiology - branch of the FSBI “Tomsk National Research Medical Center of the RAS”
Russian Federation

Tomsk, 111-A Kievskaya str.



D. N. Khomutinin
State budgetary medical centre “Regional Clinical Hospital N1” of Tyumen region
Russian Federation

Tyumen, 55th Kotovsky str.



G. V. Kolunin
State budgetary medical centre “Regional Clinical Hospital N1” of Tyumen region
Russian Federation

Tyumen, 55th Kotovsky str.



V. E. Kharats
State budgetary medical centre “Regional Clinical Hospital N1” of Tyumen region
Russian Federation

Tyumen, 55th Kotovsky str.



A. A. Nechepurenko
FSBI “Federal Center of Cardiovascular Surgery” of the MH RF
Russian Federation

Astrakhan, 4th Pokrovskaya Grove str.



I. Sh. Sagitov
State budgetary medical centre “Republican Center of Cardiology” of the Republic of Bashkortostan
Russian Federation

Ufa, 96th Stepan Kuvykin str.



N. I. Grachev
Primorsky Regional Clinical Hospital N1
Russian Federation

Vladivostok, 53th Aleutskaya str.



N. L. Sharikov
Budgetary Institution “District Clinical Hospital” of Khanty-Mansiysk Autonomous Okrug-Yugra
Russian Federation

Khanty-Mansiysk, Kalinina str., 40



S. Yu. Chetverikov
Budgetary Institution “District Clinical Hospital” of Khanty-Mansiysk Autonomous Okrug-Yugra
Russian Federation

Khanty-Mansiysk, Kalinina str., 40



D. I. Perchatkin
State budgetary medical centre “City Pokrovskaya Hospital” of Saint Petersburg
Russian Federation

St. Petersburg, 85th Bolshoy pr. VI



Yu. V. Virstyuk
Commercial Institution of Healyh “Russian Railway Company-medicine”
Russian Federation

Moscow, 2c4 Budayskaya str.



F. G. Rzaev
State budgetary medical centre “I.V. Davydovsky City Hospital”
Russian Federation

Moscow, 11th Yauzskaya str.



D. S. Lebedev
FSBI “Almazov NMRC” of the MH RF
Russian Federation

2nd Akkuratova str., Saint Petersburg



E. N. Mikhaylov
FSBI “Almazov NMRC” of the MH RF
Russian Federation

2nd Akkuratova str., Saint Petersburg



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Korobchenko L.E., Lyubimtseva T.A., Davtyan K.V., Topchyan A.G., Simonyan G.Yu., Serduk S.E., Korolev S.V., Kosonogov A.Ya., Kosonogov K.A., Tarasyuk E.S., Lubenkov K.A., Shulga A.S., Artyukhina E.A., Revishvili A.Sh., Kryzhanovskii D.V., Batalov R.E., Usenkov S.Yu., Khomutinin D.N., Kolunin G.V., Kharats V.E., Nechepurenko A.A., Sagitov I.Sh., Grachev N.I., Sharikov N.L., Chetverikov S.Yu., Perchatkin D.I., Virstyuk Yu.V., Rzaev F.G., Lebedev D.S., Mikhaylov E.N. Russian registry of cryoballon ablation of atrial fibrillation: characteristics of the procedure and features of patient’s management. Journal of Arrhythmology. 2025;32(1):5-16. https://doi.org/10.35336/VA-1447. EDN: ATOKGO

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