Contact-force guided radiofrequency ablation resulted in similar 12-month atrial fibrillation recurrence compared to second-generation cryoballoon ablation (12.0% vs 14.7%; HR 1.20; 95% CI 0.50-2.90).
Cohort (n=150)
No
Does contact-force guided radiofrequency ablation compared to second-generation balloon cryotherapy improve procedural outcomes and reduce AF recurrence at 12 months in patients with paroxysmal atrial fibrillation?
Contact-force guided radiofrequency and second-generation cryoballoon ablation show similar efficacy and safety for paroxysmal AF, though RF had shorter procedure and fluoroscopy times.
Effect estimate: HR 1.20 (95% CI 0.50-2.90)
Absolute Event Rate: 12% vs 14.7%
p-value: p=0.682
AIMS: In the setting of paroxysmal atrial fibrillation (AF), there are no available data comparing the mid-term outcome of patients undergoing pulmonary vein isolation (PVI) catheter ablation using contact-force (CF)-guided radiofrequency (RF) vs. second-generation balloon cryotherapy. METHODS AND RESULTS: Prospective single-centre evaluation, carried out from March 2011 to February 2013, comparing CF radiofrequency (Thermocool(®) SmartTouch™, Biosense Webster, Inc.) (CF group) with cryoballoon ablation (Arctic Front Advance™ 28 mm cryoballoon, Medtronic, Inc.) (CB group), in regards to procedural safety and efficacy, as well as recurrence at 12 months. Overall, 150 consecutive patients were enrolled (75 in each group). The characteristics of patients of both the groups were similar (61.2 ± 9.9 years, women 25.3%, mean AF duration 4.1 ± 4.0 years, mean CHA2DS2-VASc score 1.4 ± 1.3, mean HAS-BLED 1.4 ± 0.6). Duration of the procedure was significantly lower in the CF group (110.7 ± 32.5 vs. 134.5 ± 48.3 min, P = 0.001), with a lower duration of fluoroscopy (21.5 ± 8.5 vs. 25.3 ± 9.9 min, P = 0.017) and X-ray exposure (4748 ± 2411 cGy cm² vs. 7734 ± 5361 cGy cm², P = 0.001). In contrast, no significant difference was found regarding significant procedural complication (2.7 vs. 1.3% in CF and CB groups, respectively; P = 0.56), and PVI was eventually achieved in all cases. At 12 months, AF recurrence occurred in 11 patients (14.7%) in the CB group and in 9 patients (12.0%) in the CF group (HR = 1.20 95% CI 0.50-2.90; log rank P = 0.682). CONCLUSIONS: Our preliminary findings suggest that CF-guided radiofrequency and cryotherapy present very similar performances in the setting of paroxysmal AF catheter ablation.
Jourda et al. (Wed,) conducted a cohort in Paroxysmal atrial fibrillation (n=150). Contact-force (CF)-guided radiofrequency (RF) ablation vs. Second-generation balloon cryotherapy was evaluated on Atrial fibrillation recurrence at 12 months (HR 1.20, 95% CI 0.50-2.90, p=0.682). Contact-force guided radiofrequency ablation resulted in similar 12-month atrial fibrillation recurrence compared to second-generation cryoballoon ablation (12.0% vs 14.7%; HR 1.20; 95% CI 0.50-2.90).