Key result
LAAO with cryoballoon ablation shows similar peri-device leaks vs radiofrequency ablation but shortens procedure time.
Why the study?
Few studies have reported the efficacy and safety of cryoballoon ablation combined with LAAO, and no studies have compared combining LAAO with cryoballoon ablation versus radiofrequency ablation.
Does cryoballoon ablation combined with LAAO reduce peri-device leaks and adverse events compared to radiofrequency ablation combined with LAAO in high-risk atrial fibrillation patients?
Cohort (n=112)
No
Does cryoballoon ablation combined with LAAO reduce peri-device leaks and adverse events compared to radiofrequency ablation combined with LAAO in high-risk atrial fibrillation patients?
Cryoballoon ablation combined with LAAO offers similar safety and efficacy to radiofrequency ablation with LAAO but significantly reduces procedure time.
Answers are grounded in this paper and cite their sources.
Cryoballoon-LAAO may offer procedural efficiency with comparable safety to radiofrequency-LAAO; leaves open randomized confirmation in high-risk AF.
Background: A one-stop procedure involving catheter ablation and left atrial appendage occlusion (LAAO) is an option for high-risk atrial fibrillation patients. Few studies have reported the efficacy and safety of cryoballoon ablation (CBA) combined with LAAO, and no studies have compared the combination of LAAO with CBA or radiofrequency ablation (RFA). Methods: A total of 112 patients were enrolled in the present study; 45 patients received CBA combined with LAAO (group 1), and 67 patients received RFA combined with LAAO (group 2). Patient follow-up was performed for 1 year to detect peri-device leaks (PDLs) and safety outcomes (defined as a composite of peri-procedural and follow-up adverse events). Multivariable regression showed that PDLs risk and safety outcomes were all similar between the two groups. Subgroup analysis of PDLs indicated no significant differences. Follow-up safety outcomes were related to anticoagulant medication, and patients without PDLs were more likely to discontinue antithrombotic therapy. The total procedure and ablation times were all significantly shorter for group 1. Conclusion: When compared with left atrial appendage occlusion combined with radiofrequency, left atrial appendage occlusion combined with cryoballoon ablation has the same risk of peri-device leaks and safety outcomes, but the procedure time was significantly reduced.
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Ma et al. (2023) conducted a cohort in Atrial fibrillation (n=112). Left atrial appendage occlusion combined with cryoballoon ablation vs. Left atrial appendage occlusion combined with radiofrequency ablation was evaluated on Peri-device leaks (PDLs) (OR 0.840, 95% CI 0.380-1.857, p=0.667). Left atrial appendage occlusion combined with cryoballoon ablation resulted in a similar rate of peri-device leaks (33.3% vs. 37.3%) compared to combination with radiofrequency ablation, but significantly reduced procedure time.
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