Course of Chronic Heart Failure in the Early Period Following Catheter Cryoballoon Ablation in Paroxysmal and Persistent Atrial Fibrillation

N. G. Poteshkin; Yа. R. Shashkina; E. A. Kovalevskaya; M. V. Gorev; A. А. Karasev; I. V. Samsonova

doi:10.20514/2226-6704-2026-16-1-28-37

Course of Chronic Heart Failure in the Early Period Following Catheter Cryoballoon Ablation in Paroxysmal and Persistent Atrial Fibrillation

N. G. Poteshkin, Yа. R. Shashkina, E. A. Kovalevskaya, M. V. Gorev, A. А. Karasev, I. V. Samsonova

https://doi.org/10.20514/2226-6704-2026-16-1-28-37

EDN: PCXZBG

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Abstract

Aim. Study the course of chronic heart failure with paroxysmal and persistent atrial fibrillation (AF) during the early period after catheter cryoballoon ablation of pulmonary vein.
Material and Methods. Sixty-seven patients (mean age 65.07 ± 7.72 years, 31 (46.3 %) men) with atrial fibrillation and heart failure were divided into two groups: Group I — paroxysmal AF and Group II — persistent AF. All patients underwent primary cryoballoon ablation using standard technique. Before operation and three months post-operation, tests included six-minute walk test, Minnesota Living with Heart Failure Questionnaire, measurement of N-terminal pro-brain natriuretic peptide, and echocardiography.
Results. The NT-proBNP level was lower in Group I — 151.00 [65.50;249.00] ng/L versus 513,00 [355.25; 948.00] ng/L in Group II (p <0.001). Group II demonstrated larger left atrial dimensions: left atrial diameter 42.50[40.25;45.00] mm (p=0.018), indexed left atrial volume 40.00 [37.50;46.65] mL/m2 (p=0.023), right atrial diameter 43.00 [40.25;45.75] mm (p=0.001) and left ventricular. Left ventricular ejection fraction was lower in Group II — 55.00 [50.50;58.00] % versus 60.00 [57.00;62.00] % (p <0.001). Within-group analysis showed that Group I improved the quality of life and an increased 6-minute walk test distance from 411.0 [377.0;482.5] meters to 455.0 [420.0–515.0] meters (p=0.001). For Group II, dynamic changes revealed an increase in 6-minute walk test distance from 424.00 [390.00;500.75] to 470.00 [410.00–551.50] meters (p<0.001), a significant drop in NT-proBNP level from 513.00 [355.25;948.00] to 153.00 [73.50–171.00] ng/L (p<0.001), reduction in left atrial dimensions, right ventricular siz e, systolic pulmonary artery pressure, and an increase in left ventricular ejection fraction from 55.00 [50.50;58.00] % to 60.00 [55.00–60.00] % (p=0.004).
Conclusion. Patients with persistent atrial fibrillation, who initially had more severe chronic heart failure, experienced an improvement in their functional status, increased walking endurance, reduction in left atrial and right ventricular dimensions, as well as systolic pulmonary artery pressure, along with an increase in left ventricular ejection fraction and a decrease in NT-proBNP levels, 3 months af ter cryoballoon ablation. Patients with paroxysmal atrial fibrillation benefited from cryoballoon ablation through enhanced physical activity tolerance and improved quality of life.

Keywords

atrial fibrillation, heart failure, quality of life, cryoballoon ablation, echocardiography, left ventricular ejection fraction, NT-proBNP

About the Authors

N. G. Poteshkin

Federal State Autonomous Educational Institution of Higher Education «N.I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation (Pirogov Russian National Research Medical University) ; State Budgetary Institution “Moscow Clinical Science and Research Center 52”, Moscow Healthcare Department
Russian Federation

Natalia G. Poteshkina — MD, PhD, Professor, Head of the Department of General Therapy, Faculty of Continuing Professional Education, Institute of Personalized Medicine, Director of the University Clinic of General Therapy

Moscow

Competing Interests: