The Impact of Early Cryoballoon Ablation on Clinical Outcomes in Patients With Non-Paroxysmal Atrial Fibrillation.

BACKGROUND

Cryoballoon ablation is a safe and efficient rhythm control strategy in patients suffering from atrial fibrillation (AF). Diagnosis-to-ablation time (DAT) has been defined as a predictor of ablation outcomes, but the impact of early ablation among non-paroxysmal AF is unclear. The aim of this study was to examine the impact of early cryoballoon ablation on AF recurrence in a prospective single-center cohort of non-paroxysmal AF patients.

METHODS

Patients with non-paroxysmal AF admitted to the Second Hospital of Tianjin Medical University until July 2024 and underwent first-time cryoballoon ablation were enrolled. The patients were divided into two groups to evaluate differences in AF recurrence risk associated with early-ablation (n = 78), defined as within 6 months of first AF diagnosis, and delayed-ablation (n = 70), defined as > 6 months after first AF diagnosis. The follow up was until October 31, 2024. Cox regression models were used to identify predictors of recurrence.

RESULTS

A total of 148 subjects were included and followed up for a mean of 293 (119-398) days. The cohort included 78 (52.70%) in the early-ablation group and 70 (47.30%) in the delayed-ablation group. The mean age was 65.82 ± 9.75 years and 56 (37.84%) were female. Multivariate Cox regression analysis showed that early-ablation [hazard ratio (HR) = 0.496, 95% confidence interval (95% CI): 0.248-0.991, p = 0.047], low-density lipoprotein/high-density lipoprotein ratio (HR = 0.589, 95% CI: 0.377-0.920, p = 0.020), and early recurrence (HR = 2.750, 95% CI: 1.418-5.333, p = 0.003) were independent predictors of AF recurrence after cryoballoon ablation.

CONCLUSION

Early cryoablation reduced the risk of recurrence in patients with non-paroxysmal AF.