Timing of early recurrence predicts long-term outcomes after cryoballoon pulmonary vein isolation

Adil K. Baimbetov, Kenzhebek A. Bizhanov, A Sarsenbayeva, N Bigeldiyev, A.V. Sapunov, D Abdimalikova

2026

Деректер сенімділігі 70 орташа

Бұл баға қалай есептеледі

Ол жазбаның өзінің тексерілетін белгілерінен құралады: мақаланың DOI-і бар ма, оның деректерін қанша тәуелсіз дереккөз растады, міндетті өрістер толтырылған ба және соңғы растау қаншалықты жаңа. Дереккөздер арасындағы алшақтық пен идентификатордың болмауы бағаны төмендетеді. 80-нен бастап мән жазбаның қосымша тексерусіз жарияланғанын, 60-тан 79-ға дейін — оның сенімділігі төмен күйде жарияланғанын және қолмен тексеру ұсынылатынын білдіреді. Редактор қолмен тексерген жазбаны қайта есептеу 90-нан төмен түсірмейді. Бұл — мақаланың өзіне емес, ол туралы деректерімізге берілген баға.

Аңдатпа

Abstract Background Current guidelines recommend that atrial fibrillation (AF) recurrences within the first 90 days after pulmonary vein isolation (PVI) should not prompt immediate re-ablation; this period is therefore accepted as the "blanking period." However, accumulating data suggest that early atrial arrhythmia recurrences during this period may predict long-term outcomes. The optimal timing for considering re-ablation following early recurrence remains uncertain. Objective to evaluate whether the timing of early atrial arrhythmia recurrence during the 90-day blanking period after first-time CryoPVI predicts long-term procedural efficacy, and to determine when re-ablation should be considered. Methods We prospectively analyzed consecutive AF patients who underwent first-time cryoballoon PVI (CryoPVI) at a single center between 2019 and 2024. Patients were classified into four groups based on the timing of atrial arrhythmia recurrence during the blanking period: 0–30 days, 30–60 days, 60–90 days, and no recurrence within 90 days. CryoPVI was performed using a standardized protocol. Follow-up was conducted at 3, 6, 12, 18, 24, and 36 months. The primary efficacy endpoint was symptomatic atrial arrhythmia recurrence. Results A total of 1,222 patients underwent first-time CryoPVI. Early atrial arrhythmia recurrence occurred in 89 patients (7.3%) within 0–30 days, 44 patients (3.6%) within 30–60 days, and 41 patients (3.3%) within 60–90 days. Overall, 1,048 patients (85.8%) had no arrhythmia recurrence during the 90-day blanking period. At 36 months, the incidence of the primary efficacy endpoint was significantly higher among patients with early recurrence (0–30 days: 63.3%; 30–60 days: 71.6%; 60–90 days: 78.3%) compared with those without recurrence ≤90 days (42.3%; p < 0.0001). Conclusion Atrial arrhythmia recurrence during the first 90 days after CryoPVI is associated with significantly reduced long-term procedural efficacy. These findings suggest that re-ablation may be considered regardless of the timing of early recurrence within the blanking period.