Does the choice of ablation technology (RFC, CB, or LB) influence the incidence of asymptomatic cerebral lesions in patients undergoing AF ablation?
The incidence of asymptomatic cerebral lesions following AF ablation is approximately 22% and does not differ significantly between irrigated radiofrequency, cryoballoon, and laser-balloon technologies.
BACKGROUND: Asymptomatic cerebral lesions (ACL) may occur during atrial fibrillation (AF) ablation. We sought to compare the ACL incidence between 3 contemporary technologies: (1) irrigated radiofrequency current (RFC), (2) the single big cryoballoon (CB), and (3) the endoscopic laser-balloon (LB) in a prospective randomized pilot study. METHODS AND RESULTS: Ninety-nine patients were treated in 3 groups. Diffusion weighted MRI was acquired pre- (n = 20) and 24-48 h postablation (n = 99). After ablation, new ACL were detected in 22% of patients without significant differences between groups (RFC 8/33; CB 6/33; LB 8/33; P = 0.8). The presence of hypertension was identified as the only independent predictor of ACL by univariate regression analysis. During LB ablation, more ablation lesions (140 ± 19 vs 119 ± 18; P = 0.007) were applied during longer procedures (166 ± 36 vs 143 ± 32 min; P = 0.05) in patients with ACL. Univariate analysis revealed that a higher number of ablation lesions predicted ACL (P = 0.02). CONCLUSION: In this prospective, randomized, single-center pilot study, ablation technology did not influence the occurrence of ACL during AF ablation.
Schmidt et al. (Tue,) studied this question.