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Erschienen in:
17.05.2021 | Original Contributions
Newer generation cryoballoon vs. contact force-sensing radiofrequency ablation catheter in the ablation of paroxysmal atrial fibrillation
Erschienen in: Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 2/2021
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Background
Catheter ablation for atrial fibrillation (AF) has become an effective treatment to control symptoms. The second generation cryoballoon (CB) was designed for more efficient and homogenous freeze. Radiofrequency (RF) ablation catheters using three-dimensional electroanatomical mapping with the use of contact-force radiofrequency (CF RF) technology has achieved good results in several studies.
Objectives
To compare the efficacy and safety of second-generation CB ablation in contrast to CF RF ablation in the ablation of paroxysmal AF.
Methods
A total of 81 consecutive patients suffering from paroxysmal AF underwent pulmonary vein isolation (PVI) either by the second generation cryoballoon (n = 44) or a contact force-sensing RF catheter (n = 37). The study was conducted at Ain Shams University Hospitals and Royal Brompton & Harefield NHS trust. Baseline data, procedural data and patient follow up—at 3, 6 and 12 months—were collected and analysed.
Results
The mean age was 53.8 ± 15 years in the CB group and 62.4 ± 12 years in the RF group, females representing 40.9% and 48.6% respectively. The baseline characteristics were comparable, but the CB group had less left atrial diameter and more left ventricular ejection fraction. The CB procedure was shorter (94.4 ± 39.3 vs. 140.8 ± 44.3 min, p < 0.0001), with longer fluoroscopy time (30 vs. 15.1 min, p = 0.047). Procedural complications were comparable between the two groups (CB 4.6%, CF RF 2.7%, p = 0.411). After 1 year, the recurrence rate in the CB group was similar to RF (27.3% vs. 27% respectively, p = 0.980).
Conclusion
Second-generation CB ablation of paroxysmal AF has similar efficacy and safety to contact force-sensing RF catheters, with shorter procedure times and more fluoroscopy.