Key result
Early cryoballoon ablation is linked to ~36% fewer atrial tachyarrhythmia recurrences versus late ablation.
Why the study?
The influence of early atrial fibrillation ablation, specifically cryoballoon ablation, on clinical outcomes during long-term follow-up had not been clarified.
Does early cryoballoon ablation reduce the recurrence of atrial tachyarrhythmias in patients with atrial fibrillation?
Cohort (n=2,605)
Yes
Does early cryoballoon ablation reduce the recurrence of atrial tachyarrhythmias in patients with atrial fibrillation?
Effect estimate: HR 0.637 (95% CI 0.412-0.984)
Absolute Event Rate: 26.1% vs 31.7%
p-value: p=0.043
Early cryoballoon ablation (within 6 months of diagnosis) significantly reduces the 2-year recurrence of atrial tachyarrhythmias compared to late ablation, particularly in patients with paroxysmal atrial fibrillation.
Early cryoballoon ablation was associated with lower recurrence in paroxysmal AF; extends observational timing data but leaves open need for randomized confirmation.
INTRODUCTION: Influence of early atrial fibrillation (AF) ablation, particularly cryoballoon ablation (CBA), on clinical outcome during long-term follow-up has not been clarified. The objective was to determine whether an early CBA (diagnosis-to-ablation of ≤6 months) strategy could affect freedom from AF recurrence after index CBA. METHODS: The study included 2605 patients from Korean CBA registry data with follow-up >12 months after de novo CBA. The primary outcome was recurrence of atrial tachyarrhythmias (ATs) of ≥30-s after a 3-month blanking period. RESULTS: -VAS score. During mean follow-up of >21 months, ATs recurrence was detected in 839 (32.2%) patients. The early CBA group showed a significantly lower 2-year recurrence rate of ATs than the late CBA group (26.1% vs. 31.7%, p = 0.043). In subgroup analysis, the early CBA group showed significantly higher 1-year and 2-year freedom from ATs recurrence than the late CBA group only in paroxysmal atrial fibrillation (PAF) patients in overall and propensity score matched cohorts. Multivariate analysis showed that early CBA was an independent factor for preventing ATs recurrence in PAF (hazard ratio: 0.637; 95% confidence intervals: 0.412-0.984). CONCLUSION: Early CBA strategy, resulting in significantly lower ATs recurrence during 2-year follow-up after index CBA, might be considered as an initial rhythm control therapy in patients with paroxysmal AF.
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Kwon et al. (2023) conducted a cohort in Atrial fibrillation (n=2,605). Early cryoballoon ablation (diagnosis-to-ablation ≤6 months) vs. Late cryoballoon ablation was evaluated on Recurrence of atrial tachyarrhythmias of ≥30-s after a 3-month blanking period (HR 0.637, 95% CI 0.412-0.984, p=0.043). Early cryoballoon ablation (≤6 months from diagnosis) significantly reduced the 2-year recurrence rate of atrial tachyarrhythmias compared to late ablation (26.1% vs. 31.7%, p=0.043).
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