Cryoballoon ablation for paroxysmal atrial fibrillation mildly improves lung function: An observational study

Abstract

Atrial fibrillation (AF) is the most common arrhythmia and a major public health burden. Catheter ablation (CA) is an effective treatment of AF. Although radiofrequency catheter ablation (RFCA) is the standard practice, cryoballoon ablation (CBA) has become increasingly popular. Pulmonary dysfunction is also associated with AF. As CA targets the pulmonary vasculature, it poses a risk to lung function. However, the effect of CA on respiration in patients with paroxysmal atrial fibrillation (PAF) post-ablation has not yet been assessed. We assessed pulmonary function after CA in a cohort of patients with AF. This prospective, single-center study included 26 patients with symptomatic PAF and 18 patients without PAF. CA techniques include RFCA, CBA, hot balloon ablation, and laser balloon-mediated ablation. Spirometry parameters included vital capacity (VC), forced vital capacity (FVC), forced expiratory volume (FEV1), and peak expiratory flow, which were all measured 6 months post-ablation. AF ablation significantly improved VC (P = .04), FVC (P = .01), and peak expiratory flow (P = .006) in all the patients. In the patients with PAF, we observed a significant increase in FEV1 (P = .04). CBA significantly improved VC (P = .012) and FVC (P = .013). A significant improvement in these pulmonary parameters was achieved, specifically in patients with PAF treated with an ablation protocol with CBA, but not with RFCA or hot balloon ablation. A significant decrease in FEV1 was observed with hot balloon ablation (P = .035). Significant improvement in pulmonary parameters was observed specifically in patients with PAF who underwent CBA. CBA may be a more suitable treatment strategy for patients with PAF, particularly those with compromised pulmonary function.