Circumferential pulmonary vein isolation as index procedure for persistent atrial fibrillation: a comparison between radiofrequency catheter ablation and second-generation cryoballoon ablation
Open Access
- 12 January 2015
- journal article
- research article
- Published by Oxford University Press (OUP) in EP Europace
- Vol. 17 (4), 559-565
- https://doi.org/10.1093/europace/euu350
Abstract
To assess the 1 year efficacy of pulmonary vein isolation (PVI) as index procedure for persistent atrial fibrillation (PersAF) comparing conventional radiofrequency irrigated-tip catheter ablation (RFCA) using contact-force technology and ablation using the second-generation cryoballoon (CB-AdvA). One hundred consecutive patients (74 male, 74%; mean age 62.4 ± 9.6 years) with drug-refractory PersAF undergoing PVI using RFCA and CB-AdvA were enrolled. Follow-up was based on outpatient clinic visits including Holter-electrocardiograms. Recurrence of atrial tachyarrhythmias (ATas) was defined as a symptomatic or documented episode >30 s. Among 100 patients, 50 underwent RFCA whereas 50 CB-AdvA. Mean procedure and fluoroscopy times were 90.5 ± 41.7 vs. 140.2 ± 46.9 min and 14.5 ± 6.6 vs. 19.8 ± 6.8 min in the CB-Adv and in the RFCA group, respectively (P < 0.01). At 1 year follow-up, after a 3 months blanking period (BP), freedom from ATas off-drugs after a single procedure was 60% (28/50 patients) in the CB-Adv and 56% (27/50 patients) in the RFCA group (P = 0.71). Multivariate analysis demonstrated that PersAF duration (P = 0.01) and relapses during BP (P = 0.02) were independent predictors of ATa recurrences following the index procedure. Freedom from ATas following PersAF ablation with RFCA and CB-Adv is comparable at 1 year follow-up after a single procedure. Ablation with the CB-Adv is associated with shorter procedure time and radiation exposure as compared with RFCA. Atrial tachyarrhythmias occurrence during BP and longer time of PersAF seem to be significant predictors of arrhythmia recurrences after the index procedure.This publication has 20 references indexed in Scilit:
- Contact-force guided radiofrequency vs. second-generation balloon cryotherapy for pulmonary vein isolation in patients with paroxysmal atrial fibrillation--a prospective evaluationEP Europace, 2014
- Comparison of Pulmonary Vein Isolation Using Cryoballoon Versus Conventional Radiofrequency for Paroxysmal Atrial FibrillationThe American Journal of Cardiology, 2014
- One‐Year Follow‐Up After Single Procedure Cryoballoon Ablation: A Comparison Between the First and Second Generation BalloonJournal of Cardiovascular Electrophysiology, 2014
- Second-generation cryoballoon ablation for paroxysmal atrial fibrillation: 1-year follow-upEP Europace, 2014
- Improved Procedural Efficacy of Pulmonary Vein Isolation Using the Novel Second‐Generation CryoballoonJournal of Cardiovascular Electrophysiology, 2012
- Verification of pulmonary vein isolation during single transseptal cryoballoon ablation: a comparison between the classical circular mapping catheter and the inner lumen mapping catheterEP Europace, 2012
- Additional Ablation of Complex Fractionated Atrial Electrograms After Pulmonary Vein Isolation in Patients With Atrial FibrillationCirculation: Arrhythmia and Electrophysiology, 2011
- Electrophysiological Findings During Ablation of Persistent Atrial Fibrillation With Electroanatomic Mapping and Double Lasso Catheter TechniqueCirculation, 2005
- A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrateJournal of the American College of Cardiology, 2004
- Relation Between Pulmonary Vein Firing and Extent of Left Atrial–Pulmonary Vein Connection in Patients With Atrial FibrillationCirculation, 2004