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19.03.2020 | Ausgabe 2/2021

Journal of Interventional Cardiac Electrophysiology 2/2021

Clinical efficacy of “ICE-FIRE” ablation for non-paroxysmal atrial fibrillation

Journal of Interventional Cardiac Electrophysiology > Ausgabe 2/2021
Gang Xu, Jiageng Cai, Zhaohong Liu, Enzhao Liu, Xiangyang Jing, Tong Liu, Qitong Zhang, Lan Ye, Guangping Li
Wichtige Hinweise
Gang Xu, Jiageng Cai and Zhaohong Liu contributed equally to this work.

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Catheter ablation is less successful for non-paroxysmal atrial fibrillation (NPAF) according to numerous follow-up studies. The choice of ablation strategy for patients with NPAF remains controversial. The objective of the study was to explore the clinical efficacy of the “ICE-FIRE” ablation.


Ninety NPAF patients were enrolled. Patients were randomly divided into RF (treated with circumferential pulmonary vein isolation (CPVI) and additional substrate modification by radiofrequency ablation) group and I-F (treated with CPVI by cryoablation and additional substrate modification by radiofrequency ablation) group. After CPVI and cardioversion to sinus rhythm, high-density mapping was performed. Eight-one of 90 participants restored to sinus rhythm. Seventy-four of 81 NPAF patients showed low-voltage zone. Substrates with low-voltage zone were targeted for further modification. Participants were followed at baseline, 3, 6, 9, and 12 months after the initial ablation.


The I-F group shared more X-ray exposure (I-F, 264.4 ± 97.4 mGy; RF, 224.9 ± 62.0 mGy; P = 0.039) and less duration of the procedure (I-F, 150.3 ± 27.5 min; RF, 174.2 ± 38.5 min; P = 0.003) compared to RF group. The freedom from atrial arrhythmia recurrence at 12 months post-ablation was similar between the RF and I-F groups (RF, 57.1%; I-F, 71.8%; P = 0.197). However, I-F group experienced lower rehospitalization rate of AF recurrence (RF, 42.9%; I-F, 20.5%; P = 0.038).


In NPAF patients requiring substrate mapping and modification, the “ICE-FIRE” ablation demonstrated non-inferior clinical efficacy and lower rehospitalization rate of AF recurrence when compared with pure radiofrequency ablation strategy.

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