OBJECTIVE

To assess treatment of paroxysmal and persistent atrial fibrillation (AF) using cryoballoon ablation of pulmonary vein ostia (CBA) and antiarrhythmic therapy (AAT) in patients with cardiovascular comorbidities.

MATERIAL AND METHODS

The study included 120 patients with paroxysmal and persistent AF. Patients were randomized into 2 groups: group 1 (n=60) — CBA+AAT, group 2 — AAT alone. The follow-up period was 6 months. All patients underwent transthoracic echocardiography and Holter monitoring. We analyzed serum NT-proBNP and EHRA functional class.

RESULTS

After 6 months, 50 (83%) patients in the first group did not have episodes of AF compared to 39 (65%) patients in the second group (p=0.05). Left atrium size and volume decreased in the first group compared to the second group (p<0.001). Under stable sinus rhythm throughout 6 months after cardioversion, serum NT-proBNP decreased (115.0 [76.8; 384.2] pg/ml group in the 1^st group and 886.5 [451.5; 2183.8] pg/ml in the 2^nd group, p<0.001) and mEHRA functional class increased (class I in 58 (97%) and 31 (52%) patients in both groups, respectively).

CONCLUSION

CBA+AAT is the best method for AF in patients with cardiovascular comorbidities as this approach reduces serum NT-proBNP, improves quality of life, increases functional class and contributes to reverse cardiac remodeling.