ORAL ABSTRACTS (1)Allied Professionals7CRYOABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION - IS AN EP LAB REQUIRED?8A PATHWAY TO SAFETY - ANTICOAGULATION COMPLIANCE IN CIED PATIENTS WITH AF9UNDERSTANDING THE WAYS IN WHICH OCCUPATION IS AFFECTED BY POSTURAL TACHYCARDIA SYNDROME: A UK OCCUPATIONAL THERAPY PERSPECTIVE10DEVELOPMENT OF AN INTERGRATED SUPPORT PATHWAY FOR PATIENTS FULFILLING NICE CRITERIA FOR AN INTERNAL CARDIOVASCULAR DEBRIBRILLATOR (ICD) IN A DISTRICT GENERAL HOSPITAL11ARE CARDIOVASCULAR RISK FACTORS ALSO ASSOCIATED WITH THE INCIDENCE OF ATRIAL FIBRILLATION? A SYSTEMATIC REVIEW AND FIELD SYNOPSIS OF 23 FACTORS IN 32 INITIALLY HEALTHY COHORTS OF 20 MILLION PARTICIPANTS12BRAIN MRI FINDINGS IN PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING CARDIOVERSIONBasic Science/Sudden Cardiac Death13PRELIMINARY ASSESSMENT OF THE “RE-ENTRY VULNERABILITY INDEX” AS A MARKER OF CARDIAC INSTABILITY IN THE HUMAN HEART USING WHOLE-HEART CONTACT EPICARDIAL MAPPING14OPTOGENETIC STIMULATION OF BRAINSTEM'

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Introduction: Cryoablation is an effective technique for pulmonary vein isolation (PVI) for the treatment of paroxysmal AF (PAF). The Artic Front Advance™ Cryoballoon (Medtronic) is the second generation device with high rates of acute and chronic success. Rates of acute PVI are as high as 98% with cryoablation alone and it is unclear whether pulmonary vein mapping increases the long term clinical outcomes of the procedure. Methods: Consecutive patients undergoing first ablation for PAF were included in a single centre, retrospective, non-randomised study. The choice to use PV mapping was determined by availability of an EP recording system in the cath lab. Procedures were performed under conscious sedation and transseptal puncture guided by fluoroscopy only. When EP equipment was not available diaphragmatic monitoring was conducted by phrenic nerve pacing using a temporary pacing box. A 28mm Artic Front Advance balloon was used in all cases. Two 3 minute freezes were applied per vein. For cryo-map cases PVI was not verified. In cryo-map cases isolation was confirmed using a circular mapping catheter. Further ablation was then performed as required. Results: 110 patients were evaluated (60 cryo-map and 50 cryo-no map). Procedure, fluoroscopy and cryo-ablation times were all shorter cryo-no map vs cryo map: 82 ± 17 vs 111 ± 29 minutes, 20 ± 10 vs 30 ± 13 minutes and 1433 ± 158 vs 1796 ± 359 seconds respectively (p all <0.01). Freedom from AF at 12months showed no significant difference between cryo-no map (80.5%) vs. cryo-map (75.5%). Mean time to recurrence was similar between the 2 groups: 10.6 months with cryo-Map vs 10.4 months with cryo-no map (p = 0.55). Conclusions: The cryo no-map approach demonstrates the potential of multiple cost savings as it does not require a PV mapping catheter, EP recording equipment or a designated lab. These results suggest that these cost savings could be implemented without compromising patient outcome. Further work in a randomised and larger study is required to confirm these findings.

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