Table 1.
Patient demographics and factors associated with VLRAF
| Variable | All patients (n = 300) | VLRAF (n = 77) | No VLRAF (n = 223) | p (VLRAF vs. no VLRAF) |
|---|---|---|---|---|
| Age | 62.0 ± 9.9 | 61.3 ± 10.4 | 62.3 ± 9.7 | 0.46 |
| Age > 65 | 127 (42.3%) | 34 (44.2%) | 93 (41.7%) | 0.71 |
| Male gender | 200 (66.6%) | 51 (66.2%) | 149 (66.8%) | 0.93 |
| Active smoker | 22 (7.3%) | 4 (5.2%) | 18 (8.1%) | 0.40 |
| Rhythm | ||||
| pAF | 159 (53.0%) | 28 (36.4%) | 131 (58.7%) | 0.001 |
| PeAF | 118 (39.3%) | 41 (53.2%) | 77 (34.5%) | 0.004 |
| LPeAF | 23 (7.7%) | 8 (10.4%) | 15 (6.7%) | 0.30 |
| Number of months of AF | 48.9 ± 60.9 | 55.7 ± 72.2 | 46.5 ± 56.6 | 0.27 |
| Structural heart disease | 40 (13.3%) | 15 (29.5%) | 25 (11.2%) | 0.06 |
| Pre-existing implantable defibrillator/Pacemaker | 20 (6.7%) | 5 (6.5%) | 15 (6.7%) | 0.94 |
| Left ventricular ejection fraction (%) | 56.8 ± 9.0 | 54.4 ± 11.4 | 57.7 ± 7.8 | 0.006 |
| Left ventricular ejection fraction < 55% | 113 (37.7%) | 36 (47.4%) | 77 (36.0%) | 0.080 |
| Left bundle branch block | 13 (4.4%) | 8 (10.4%) | 5 (2.3%) | 0.003 |
| Left atrium diameter (mm) | 39.2 ± 7.1 | 40.6 ± 7.5 | 38.8 ± 6.9 | 0.051 |
| LA diameter > 40 mm | 110 (37.9%) | 33 (44.6%) | 77 (35.6%) | 0.17 |
| LA diameter > 43 mm | 85 (29.3%) | 29 (39.2%) | 56 (25.9%) | 0.031 |
| LA diameter > 47 mm | 41 (14.1%) | 15 (20.3%) | 26 (12.0%) | 0.079 |
| Left atrium diameter index | 18.9 ± 3.6 | 19.4 ± 3.6 | 18.7 ± 3.6 | 0.14 |
| Left atrium diameter index > 23 | 30 (10.3%) | 12 (16.2%) | 18 (8.3%) | 0.14 |
| Body mass index | 29.4 ± 6.1 | 29.2 ± 5.3 | 29.5 ± 6.4 | 0.73 |
| Body surface area (m2) | 2.09 ± 0.28 | 2.11 ± 0.26 | 2.09 ± 0.28 | 0.61 |
| Active alcohol intake | 156 (52.0%) | 34 (44.7%) | 122 (54.7%) | 0.13 |
| Glomerular filtration rate (mL/min) | 78.7 ± 17.4 | 77.1 ± 17.1 | 79.3 ± 17.5 | 0.37 |
| Comorbid conditions | ||||
| Hypertension | 142 (47.5%) | 35 (45.5%) | 107 (48.2%) | 0.68 |
| Diabetes | 35 (11.7%) | 7 (9.1%) | 28 (12.6%) | 0.41 |
| Cerebrovascular accident | 19 (6.3%) | 2 (2.6%) | 17 (7.6%) | 0.12 |
| Coronary artery disease | 45 (15.0%) | 19 (24.7%) | 26 (11.7%) | 0.006 |
| Obstructive sleep apnea | 41 (13.7%) | 9 (11.7%) | 32 (14.3%) | 0.56 |
| Metabolic syndrome | 86 (34%) | 21 (30.4%) | 65 (35.4%) | 0.46 |
| Medications | ||||
| On ACE-i | 103 (34.6%) | 32 (41.6%) | 71 (32.1%) | 0.13 |
| On calcium channel blocker | 61 (20.4%) | 12 (15.6%) | 49 (22.1%) | 0.22 |
| On statin | 130 (43.6%) | 37 (48.1%) | 93 (42.1%) | 0.36 |
| On beta blocker | 171 (57.0%) | 45 (58.4%) | 126 (56.5%) | 0.77 |
| Prior Ablation | 50 (16.7%) | 13 (16.9%) | 37 (16.6%) | 0.95 |
| Procedural data | ||||
| 28 mm Arctic front balloon used | 292 (97.3%) | 76 (98.7%) | 216 (96.8%) | 1 |
| 23 mm Arctic Front Balloon Used | 8 (2.7%) | 1 (1.3%) | 7 (3.1%) | 0.39 |
| Left common Os | 18 (6.0%) | 5 (6.5%) | 13 (5.8%) | 0.83 |
| Total freezes (No.) | 9.5 ± 2.7 | 9.8 ± 2.7 | 9.4 ± 2.7 | 0.33 |
| Electrical cardioversion performed | 81 (27.0%) | 25 (32.5%) | 56 (25.1%) | 0.21 |
| Pharmacologic cardioversion performed | 8 (2.7%) | 3 (3.9%) | 5 (2.2%) | 0.44 |
| Spontaneous cardioversion observed | 32 (10.7%) | 5 (6.5%) | 27 (12.1%) | 0.17 |
| Adenosine administered | 50 (16.7%) | 15 (19.5%) | 35 (15.7%) | 0.44 |
| Isoproterenol administered | 29 (9.7%) | 4 (5.2%) | 25 (11.2%) | 0.12 |
| Procedure results | ||||
| Normal sinus rhythm following procedure | 298 (99.3%) | 77 (100%) | 221 (99.1%) | 0.40 |
| ERAF | 55 (18.3%) | 25 (32.5%) | 30 (13.5%) | <0.001 |
| VLRAF | 77 (25.7%) | x | x | x |
| Days of follow-up | 995 ± 490 | 1128 ± 494 | 949 ± 480 | 0.006 |
| Risk scores | ||||
| CHADS2 score | 0.81 ± 0.78 | 0.73 ± 0.77 | 0.83 ± 0.78 | 0.36 |
| CHA2DS2VASc score | 1.9 ± 1.3 | 1.87 ± 1.37 | 1.88 ± 1.24 | 0.95 |
| MB-LATER | 1.9 ± 1.4 | 2.50 ± 1.40 | 1.71 ± 1.29 | <0.001 |
| APPLE | 1.4 ± 1.1 | 1.73 ± 1.03 | 1.15 ± 1.01 | 0.004 |
| ALARMEc | 1.2 ± 1.0 | 1.44 ± 1.02 | 1.15 ± 1.01 | 0.06 |
| BASE-AF2 | 1.8 ± 1.3 | 2.17 ± 1.20 | 1.69 ± 1.25 | 0.02 |
| SCALE-CryoAF | 3.2 ± 2.9 | 5.03 ± 3.08 | 2.58 ± 3.08 | <0.001 |
pAF, paroxysmal atrial fibrillation; PeAF, persistent atrial fibrillation; LPeAF, longstanding persistent atrial fibrillation; NPAF, non-paroxysmal atrial fibrillation; AF, atrial fibrillation; LA, left atrium; BSA, body surface area; LA Diameter Index, left atrial diameter divided by body surface area; BMI, body mass index; CVA, cerebrovascular accident; TIA, transient ischemic attack; OSA, obstructive sleep apnea; CBA, cryoballoon ablation; AAD, antiarrhythmic drugs; ACE-i, angiotensin-converting enzyme inhibitor; CCB, calcium channel blocker; PV, pulmonary vein; ERAF, early return of atrial fibrillation (< 3 months post-procedure)