Feasibility and safety of cryoballoon ablation for the treatment of atrial fibrillation in patients with congenital heart disease

Table 1 Baseline characteristics

	n = 10
Age, yr	57.9 (48.2-61.7)
Female gender, n (%)	6 (60.0)
Type of congenital heart disease, n (%)
Simple	8 (80.0)
Atrial septal defect	6 (60.0)
Atrial and ventricular septal defects	1 (10.0)
Quadricuspid aortic valve with aortic stenosis	1 (10.0)
Moderate	2 (20.0)
Sinus venosus atrial septal defect with PAPVR	1 (10.0)
Aortic coarctation with persistent left superior vena cava	1 (10.0)
Age at repair, yr	44.3 (12.9-54.7)
Hypertension, n (%)	5 (50.0)
Dyslipidemia, n (%)	3 (30.0)
Diabetes mellitus, n (%)	1 (10.0)
Body mass index > 30 kg/m2, n (%)	2 (20.0)
Current smoker, n (%)	1 (10.0)
Coronary artery disease, n (%)	3 (30.0)
Symptoms/signs associated with atrial fibrillation, n (%)
Palpitations	10 (100.0)
Dyspnea	8 (80.0)
Congestive heart failure	2 (20.0)
Prior hospitalization for atrial fibrillation, n (%)	7 (70.0)
Left ventricular ejection fraction, %	60 (55-60)
Left atrial volume, mL/m2	34.5 (27.3-44.0)
Pattern of atrial fibrillation, n (%)
Paroxysmal	8 (80.0)
Persistent	2 (20.0)
Time from diagnosis of atrial fibrillation to procedure, yr	4.6 (0.9-10.3)
Number of antiarrhythmic drugs tried	2 (2-3)
Pharmacological therapy, n (%)
Antiarrhythmic drug	10 (100.0)
Beta-blockers	7 (70.0)
Amiodarone	3 (30.0)
Sotalol	2 (20.0)
Flecainide	2 (20.0)
Propafenone	1 (10.0)
Dofetilide	1 (10.0)
Dronedarone	1 (10.0)
Angiotensin converting enzyme inhibitor/angiotensin receptor blocker	4 (40.0)
Anticoagulant	8 (80.0)
Diuretic	2 (20.0)

Continuous variables are expressed as median and interquartile range (25^th-75^th percentile). PAPVR: Partial anomalous pulmonary venous return.

Table 2 Individual patient characteristics

Patient #	Age(yr)	Sex	CHD	Type of repair	Age at repair(yr)	Age at first AF(yr)	AF pattern	Number AADs	LA volume (mL/m2)
1	46.4	F	ASD + VSD	Surgical patch	1.5	38.5	Paroxysmal	5	27
2	55.8	F	ASD	Percutaneous device	55.7	55.3	Paroxysmal	5	52
3	60.0	F	SVASD + PAPVR	Surgical patch	44.3	46.3	Paroxysmal	2	26
4	69.2	F	ASD	Percutaneous device	53.7	67.8	Paroxysmal	2	45
5	69.5	F	ASD	Surgical patch	24.3	68.6	Paroxysmal	2	39
6	62.3	F	ASD	None	N/A	61.4	Paroxysmal	2	23
7	15.4	M	AoCo + LSVC	Surgical AoCo repair	0.0	14.4	Paroxysml	3	30
8	59.9	M	Quadricuspid AS	Aortic valvuloplasty	59.0	37.9	Persistent	3	45
9	38.8	M	ASD	None	N/A	28.5	Paroxysmal	2	28
10	53.4	M	ASD	None	N/A	53.0	Persistent	2	41

CHD: Congenital heart disease; AF: Atrial fibrillation; AAD: Antiarrhythmic drug; LA: Left atrial; F: Female; M: Male; ASD: Atrial septal defect; SVASD: Sinus venosus ASD; PAPVR: Partial anomalous pulmonary venous return; AoCo: Aortic coarctation; LSVC: Left superior vena cava; AS: Aortic stenosis; N/A: Not applicable

Table 3 Procedural characteristics

	n = 10
Access to the left atrium, n (%)
Across an atrial septal defect	3 (30.0)
Trans-septal puncture across the native septum	5 (50.0)
Trans-septal puncture across a surgical patch	2 (20.0)
Trans-septal puncture across a percutaneous closure device	0 (0.0)
Cryoballoon size, n (%)
23 mm	4 (40.0)
28 mm	7 (70.0)
Total cryoablation time, s
Left superior pulmonary vein	374 (252-475)
Left inferior pulmonary vein	480 (240-480)
Left common pulmonary vein	480 (480-700)
Right superior pulmonary vein	360 (261-453)
Right inferior pulmonary vein	315 (247-450)
Number of applications
Left superior pulmonary vein	2 (1.5-2.0)
Left inferior pulmonary vein	1 (1.0-2.0)
Left common pulmonary vein	2 (2.0-3.5)
Right superior pulmonary vein	2 (1.25-2.75)
Right inferior pulmonary vein	2 (1.0-2.0)
Minimal temperature reached, oC
Left superior pulmonary vein	-49 (-49, -51)
Left inferior pulmonary vein	-45 (-41, -52)
Left common pulmonary vein	-48 (-46, -54)
Right superior pulmonary vein	-45 (-40, -51)
Right inferior pulmonary vein	-45 (-39, -54)
Total procedural time, min	183.0 (152.5, 224.0)
Total fluoroscopy time, min	33.5 (27.5-43.0)

Continuous variables are expressed as median and interquartile range (25^th-75^th percentile).