1165The incidence of complications in the setting of second-generation cryoballoon ablation of atrial fibrillation: a comparison between vitamin K antagonists and novel oral anticoagulants

Abstract

Introduction: Data evaluating the impact of the periprocedural administration of novel oral anticoagulants (NOACs) on complications in the setting of pulmonary vein (PV) isolation using cryoballoon (CB) is limited.. Purpose: We sought to analyse the incidence of complications in having undergone CB ablation for atrial fibrillation (AF) and the impact of NOACs on adverse events compared to vitamin K antagonists (VKA). Methods: Consecutive patients with drug resistant AF who underwent PV isolation by CB as index procedure were enrolled. In group I, 290/454 (63.9%) patients received VKAs (warfarin: n=222; acenocoumarol: n=68), and in group II, 164/454 (36.1%) patients were treated with NOACs (rivaroxaban: n=71; dabigatran: n=60; and apixaban: n=33). Results: During the study period 454 consecutive patients (male 71%, age 60.1±10.9 years) were enrolled. Major complications occurred in 9 patients (2.0%): peripheral vascular complications were observed in 6 patients (1.3% per procedure), persistent phrenic nerve palsy (PNP) occurred in 2 (0.4%), and transient ischemic attacks (TIA) in 1 (0.2%). In both groups, the incidence rate of major complications was similar (2.4% vs 1.2%; p=0.5). Conclusions: Cryoballoon ablation is a safe procedure for PV isolation and is associated with low complication rates. The incidence of adverse events in PV isolation using CB with the periprocedural administration of NOACs is not significantly different than VKA treatment.